Reports send separate warning shots to English and Scottish governments on social care reform

Separate reports have highlighted how years of failed government promises on reform have left broken adult social care systems in both England and Scotland.

In England, MPs on the Commons health and social care committee published a report this week warning of the “human and financial cost of inaction” on reform of a “failing system”.

And in Scotland, two disabled people’s organisations (DPOs) and four umbrella bodies have combined in a new paper to raise concerns about the “debacle” of Scottish attempts at reform since an independent review was published more than four years ago, which have left adult social care in an “increasingly perilous state”.

The health and social care committee called on the UK government to commission research that would quantify the “cost of doing nothing on adult social care reform”, including the costs to disabled and older people, carers and care workers, local authorities, care providers, the NHS and the wider economy.

It said this research would enable the government to “start building the public and political support it will need to guarantee the longevity of reform”.

And the report called on the government to publish an annual assessment of the level of unmet care needs for both older people and working-age disabled adults in England.

The report says: “The Government needs to fundamentally change how it views the social care sector, seeing it as an enabler and talking about it in those terms in the public debate – both for the invaluable service it provides to so many people and also as a driver of economic growth.”

It also criticises the government’s lack of official data and its apparent ignorance of the potential benefits of a reformed system, while it continues to pay £32 billion a year for “a broken system”.

And it says that every £1 invested in social care would generate a £1.75 return to the economy, while an extra £1 billion spent on social care would create 50,000 jobs across the country.

Layla Moran, the committee’s Liberal Democrat chair, said the social care sector had “enormous potential to contribute to the government’s wider agenda on economic growth and employment”.

Health and social care secretary Wes Streeting told MPs on Tuesday that he would “look carefully” at the committee’s report.

The report was published days after the Department of Health and Social Care (DHSC) published the terms of reference for the three-year independent commission into adult social care, which is being chaired by Baroness [Louise] Casey.

The first phase, to report next year, will examine how to implement a National Care Service by taking a “data-driven deep-dive into the current system”.

It will examine the support needs of older people and working-age disabled people separately.

DHSC said the commission should produce “tangible, pragmatic recommendations that can be implemented in a phased way over a decade” and aim to make the system “more productive, preventative and to give people who draw on care, and their families and carers, more power in the system”.

The commission’s second phase, reporting in 2028, should make “longer-term recommendations for the transformation of adult social care”, DHSC said.

Meanwhile, six organisations have warned in a discussion paper that the Scottish government’s need to “grip the problem” of adult social care is greater than ever.

DPOs Glasgow Disability Alliance and Inclusion Scotland worked on the paper with Coalition of Carers in Scotland, Coalition of Care and Support Providers in Scotland, Health and Social Care Alliance Scotland, and Scottish Care.

They spoke out to raise concerns about the lack of progress on reform of care and support since the publication of the Independent Review of Adult Social Care in Scotland.

The review, published in February 2021, was authored by Derek Feeley, the Scottish government’s former director general for health and social care, and it was commissioned by the Scottish government.

They say in the paper that disabled and older people who receive care and support, and carers, have been “left to look on from the margins”, with their needs and rights not being met, while the sustainability of social care in Scotland “has slid into an increasingly perilous state”.

In January, the Scottish government scrapped its plans for a National Care Service, which had already been scaled back and delayed, and which the paper says was a “fundamental pillar” of the reforms.

The six organisations say they are “profoundly disappointed” at the government’s failure to secure consensus on its reforms, which led to the “jettisoning” of much of its planned legislation at a “critical time for social care support”.

And they express “dismay” in their paper at the “debacle” of the last four years of attempted reform.

The Feeley review had called for a human rights-based approach to social care through a new National Care Service on an equal footing with NHS Scotland, with accountability for social care moving from local government to Scottish government ministers.

But the new paper highlights the lack of progress since the Feeley review and warns: “Four years later we are scarcely any further forward.”

It says the passage of proposed legislation was dominated by disagreement between the Scottish government and the Convention of Scottish Local Authorities, and that the “protection of vested interests” prevented the culture change necessary to achieve the necessary reform.

Although it welcomes some of the measures that are set to proceed through the Scottish government’s care reform (Scotland) bill, the paper warns that “the reform required to meet need and respect, protect and fulfil people’s rights to independent living and provide access to timely, acceptable and quality social care support, cannot be delivered through piecemeal changes”.

The paper calls on the Scottish government to focus on developing consensus on the purpose of a human rights-based National Care Service; the importance of oversight and accountability at a national level, probably through an arms-length government agency; ethical commissioning and procurement of care and support services; and the need for transparency on funding and investment.

A note from the editor:

Please consider making a voluntary financial contribution to support the work of DNS and allow it to continue producing independent, carefully-researched news stories that focus on the lives and rights of disabled people and their user-led organisations.

Please do not contribute if you cannot afford to do so, and please note that DNS is not a charity. It is run and owned by disabled journalist John Pring and has been from its launch in April 2009.

Thank you for anything you can do to support the work of DNS…