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DH-written social care green paper could 'lack weight with Treasury'

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The prime minister’s decision to move responsibility for reforming social care funding from the Cabinet Office to a renamed Department of Health & Social Care is no guarantee the issue will finally be properly addressed, experts have warned. 

As part of the government reshuffle yesterday, Theresa May is widely believed to have been thwarted in attempts to move Jeremy Hunt from his health secretary role. He emerged with a new job title as “secretary of state for health and social care”.

In practice it is unclear what difference the new title makes as the Department of Health has always had social care under its remit, while the Department for Communities & Local Government – also yesterday renamed, and now the Ministry for Housing, Communities & Local Government – distributed funding for social care as part of its overall council finance remit.

A DHSC spokesperson said the addition or detail of any new responsibilities is yet to be decided, while a MHCLG spokesperson deferred LGC’s enquiries to the former department.

However, the DH also confirmed responsibility for the forthcoming green paper on reforming social care funding will move from the Cabinet Office, where it had been former first secretary Damian Green’s responsibility, into Mr Hunt’s remit.

Local government experts today voiced fears that work on the social care green paper – already delayed from last autumn to this summer – will be slowed down as a result of the move.

Richard Humphries, senior fellow – policy, the King’s Fund, said: “In the short term, there is a risk that momentum will be lost as the team [working on the green paper] is drawn from across Whitehall. You can’t assume it will all move, lock stock and barrel, to the DH.

“The deeper concern is whether the DH will have the same clout as the Cabinet Office in negotiating a new funding settlement from the Treasury. Social care is a challenge for the whole of government, and the risk of hiving it off to one spending department means it will be competing against all other spending departments.”

He added: “The DH has a long track record of producing green papers on social care but will the next one make any difference?”

Mr Humphries said, however, that there might be some gain in lining up NHS and local government funding settlement periods.

“On the plus side, Mr Hunt has been arguing that the NHS needs 10-year funding settlements, so if the NHS needs this, so does social care,” he said.

New Local Government Network director Adam Lent said: “Social care is not a health issue; it’s a health, local government and Treasury issue.

“Having [the green paper] located with the first secretary of state allowed cross-departmental working, with a big beast who could influence the Treasury. This sends the wrong message and risks [social care] being part of the NHS, which it isn’t. I don’t think Mr Hunt will have the same weight with the Treasury.”

Mr Lent said the DH did not have a good track record on working collaboratively with local government on social care, taking a “finger-wagging and condescending” attitude, and that this did not “bode well” for the green paper. 

However, Liam Booth-Smith, chief executive of Localis, said some in the sector were “being churlish” about the social care moves.

”People were upset that social care was downgraded to a parliamentary undersecretary of state role a few years ago. Now it is part of a secretary of state, cabinet-level brief,” said Mr Booth-Smith.

“All of the big problems [in social care] were not going to be solved by a reshuffle,” he said, adding that although this move falls short of “a cabinet minister for social care”, it is a step in that direction. 

Izzi Seccombe (Con), chair of the Local Government Association’s community wellbeing board, said: “Social care faces an annual funding gap of £2.3bn by 2020.

“It is vital that adult social care is placed on an equal footing to the NHS so the government needs to follow up yesterday’s encouraging step with action to inject further much-needed funding into social care in the final local government finance settlement. This is the best way to ensure people get the care and support they deserve and to alleviate the pressure on the NHS.”

Glen Garrod, vice president of the Association for the Directors of Adult Social Services, said of Mr Hunt’s new job title: “This is a welcome recognition of the importance of social care. We hope the secretary of state will see social care as crucial in its own right, and not just viewed through the prism of what it can do for healthcare.”

Mr Garrod said it was “essential” for the DHSC to find a “long-term, sustainable funding solution” for social care and urged the department to publish the green paper in the summer as planned.


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