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You wait ages for some proposals on solving the funding crisis in adult social care and then three come along at once.
Admittedly none of them are the long-awaited social care green paper and none come directly from the current government. However, in the social policy drought known as Brexit anything that helps spark a meaningful debate is to be welcomed.
The most weighty of the contributions came from former de facto deputy prime minister Damian Green who, before he left government under something of a cloud in late 2017, was in charge of said social care green paper. In a report published today in conjunction with the well connected right-wing thinktank Centre for Policy Studies, Mr Green proposes a new universal care entitlement which would entitle everybody to a decent level of care, of a higher quality than currently available for free, but with the freedom for individuals to pay extra for the “bells and whistles”.
Local government would continue to be responsible for delivering care and assessing needs but the funding for this would come from central government via a similar system to the NHS tariff, which pays a set rate for defined procedures. Mr Green advocates only limited change to domiciliary care but warns the care home sector is in crisis and desperately needs more funding in the short term and the prospect of sustained funding in future to drive investment.
He proposes filling the funding gap – which he puts at £2.75bn – through taxing the winter fuel allowance and a 1% surcharge on national insurance for the over 50s. He does suggest the latter could be avoided by looking elsewhere for savings in the forthcoming spending review but after a decade of austerity this seems unlikely. If Mr Green is aware of a part of the public sector with untapped capacity for savings you would have hoped he would have shared it with his government colleagues before now.
In their contribution to the debate last week, the Lords committee on intergenerational fairness also said the government should consider taxing the winter fuel allowance along with other pensioner benefits. While the report is focused on ensuring fairness between age groups throughout the taxation system and does not make specific recommendations for the future funding of social care, it warns that “social care costs cannot unfairly be loaded on the young, or remitted, in public debt, to future generations”.
Last week also saw the Labour party announce that in government it would invest £2.8bn to offer care to an extra 160,000 individuals whose needs are currently going unmet. It said the investment, part of the £8bn over five years pledged in its 2017 manifesto, would reverse cuts made since 2015. However, the party had less to say on how it would fund the extra investment; the manifesto said there were “different ways the necessary monies can be raised” including “wealth taxes, an employer care contribution or a new social care levy”.
Mr Green in his report dismisses Labour’s proposal for a national care service as “ruinously expensive” while his proposals for individuals to be able to pay extra for better quality of care has already attracted ire on the left, echoing as it does the debate over top-up fees in the NHS.
Consensus may still be a way off but at least we are talking about the issue again. As the Association of Directors of Adult Social Services spring seminar gets underway today, let’s hope this conversation continues, even if government attention remains elsewhere.
Sarah Calkin, deputy editor