Report for Labour rules out early end to care charges

A report set to have a significant influence on Labour’s adult social care policy at the next general election has ruled out an immediate end to care charges in favour of a more gradual move towards “affordability”.

The report, launched this morning (Thursday) by the Fabian Society, was commissioned by the public service union UNISON after shadow health and social care secretary Wes Streeting asked the think tank to examine how to introduce a National Care Service in England.

As suggested in a draft version of the document leaked to Disability News Service in March, the report rules out an immediate end to care charging under a Labour government.

Instead, the union-commissioned report suggests that the priority for a new Labour government should be “addressing the immediate workforce crisis” by ensuring “sufficient, properly rewarded and well-trained staff”.

It concludes that, due to the “competing financial pressures facing the system”, charging reform “should not be the first priority for extra money” and should only be “progressed gradually alongside other changes”.

It adds: “The launch of a National Care Service should not mean immediately jumping to a position where most support is free at the point of need.”

The Fabian Society appears to have dropped the recommendation in the draft report that spending on social care should increase by at least six to seven per cent above inflation each year for 10 years.

Instead, it merely suggests that the government should make “a 10-year spending commitment to significantly raise expenditure in real terms every year, and commission independent advice on the amount needed”.

Today’s report also suggests that a new Labour government should take some “immediate steps” on charging reform, such as making all short-term care free or uprating means-testing thresholds.

But rather than offering an end to care charges, the report suggests that the National Care Service (NCS) should provide “services for everyone with support needs, regardless of their means, and affordable to all”.

It adds: “The central task for social care reform should be to ensure that the right support is available to everyone who needs it.

“Achieving fair and affordable care payments can follow.”

But despite painting a grim picture of social care in England, with local authorities being forced to ration care and support, and a £6.1 billion funding gap, there appears to be no mention in the report of the debt crisis facing disabled people who pay for social care in their own homes.

Research by disabled campaigners showed last year that tens of thousands of disabled people across the country every year were having debt collection action taken against them by their local authorities over unpaid care charges.

But instead of an immediate end to charging, today’s report suggests that “one or two” significant care charging reforms could coincide with the eventual launch of the National Care Service.

This might take place in the summer of 2028 – likely to be four years after an election – with the government then announcing a “timetable of further charging changes”.

Options for these initial reforms could include offering free care and support for all people who become disabled before the age of 25, or funding free support for people with “very significant support and clinical needs”.

It suggests that ministers should then “develop a timetable of further charging changes so that people will know that the affordability of support will improve over time”.

Reclaiming Our Futures Alliance was critical of the report’s failure to address the “inequity of social care charging” when the draft version was leaked to DNS, saying then that “charging for social care is regressive and is a tax on disability” and that a National Care Service “needs to be free at the point of use, like the NHS”.

Despite the likely frustration over its suggestions on charging, some proposals in today’s report could appeal to the disabled people’s movement.

It emphasises the importance of “choice and control” for disabled people who use care and support services so they have new rights to choose where they live, while the National Care Service (NCS) would be “rights based”.

It also says that co-production should be placed at the centre of the NCS, with a new co-production duty for ministers and an independent “scrutiny, evidence and engagement body” led by people who require support and carers.

And it calls for a new legal right to independent living, as laid out in article 19 of the UN Convention on the Rights of Persons with Disabilities.

The proposals are described as a “roadmap” towards a National Care Service, and the paper will feed into Labour’s policy review in the run-up to the general election.

At this morning’s launch, Streeting said he needed “to make it crystal clear that today’s report is not Labour party policy” and that the party’s general election manifesto would be “fully costed and fully funded”.

He said Labour “won’t be making any promises in our manifesto unless we are 100 per cent sure we can keep them”.

Streeting added: “People who receive and deliver care have been let down time and again by broken Tory promises. I’m not going to repeat their mistakes.”

He said Labour would be consulting with “care providers, care workers and, crucially, with care users” in “the coming months”.

He said: “I am committed to making sure that our policies are co-produced in partnership with them, people who are experts by experience, either of receiving care or of delivering care.”

One of the two authors of the report, Ben Cooper, is disabled, but the report’s acknowledgements section suggests there were few meetings held with other disabled people and disabled people’s organisations.

Party members approved a motion at last autumn’s Labour conference that called for a National Care Service that was co-produced with service-users, publicly funded, and free of charge.

Labour’s party conference in 2019 approved plans for a National Independent Living Service model for social care reform, devised by the disabled people’s movement and backed by Labour leader Keir Starmer during his Labour leadership campaign three years ago.

But Labour has since backed away from the idea of free social care, with the party’s shadow leader of the Commons, Thangam Debbonaire, telling female party members in 2021 that introducing free social care for disabled and older people would just “give the Tories a stick to beat Labour with”.

Picture: Svetlana Kotova, from Inclusion London, which is campaigning for an end to care charges, outside the Fabian Society launch event. Photograph by Jon Abrams

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