Living the lives we want to lead

Years of significant underfunding of councils, coupled with rising demand and costs for care and support, have combined to push adult social care services to breaking point.

The Government’s decision in June to further delay its long-awaited Green Paper on the issue prompted the LGA to take action and publish its own green paper and public consultation (see first 627).

We received more than 540 submissions – from the public, service users, councils and dozens of other interested parties.

“What shines through is the passion for supporting and improving people’s wellbeing, and the role social care and other linked services can, and should, play in enabling people to live the lives they want to lead

The responses make it clear beyond doubt: doing nothing is no longer an option.

What shines through is the level of passion for supporting and improving people’s wellbeing, and the role social care and other linked services can, and should, play in enabling people to live the lives they want to.

Find out more

To view the full consultation response and the LGA’s original social care green paper, please visit www.futureofadultsocialcare.co.uk.

Some 20 years of failed or aborted attempts at reforming social care funding by governments of all colours may have frustrated people, but it has quite evidently not dulled their enthusiasm for bringing about change.

This is not to say that the Government’s task is suddenly an easy one. But there are two key lessons that it can take from the work we have done.

First, there is clear consensus on key elements of the debate – especially that the current situation is unsustainable and is failing people on a daily basis, and that adult social care matters in its own right.

Second, there is an equally important element of willingness running through the debate – willingness to engage with the difficult questions and, most crucially, to accept the type of solutions that are needed to secure social care, but which may hitherto have been considered politically unpalatable or inexpedient.

Willingness is a powerful force in this sense and one that the Government must, at the very least, explore further. As the sector and the public begin to coalesce around an understanding that fundamental solutions are needed – such as national tax rises or a comprehensive social insurance solution – they will simply not accept a roadmap for change that dodges the difficult questions, let alone the difficult decisions.

The recommendations we have made to government (see opposite) are aimed at achieving two broad objectives: stabilising and sustaining the current care system now; and moving towards a future system that we know could be better.

‘Better’ is not about doing more of what we are doing now, but moving toward the real purpose and intent of the Care Act 2014. While not perfect, the Act’s principles are fundamentally sound: a genuine focus on people and their wellbeing being at the heart of care and support; a real commitment to prevention and doing everything possible to keeping people fit and well at home; meeting all needs with quality services, delivered by a thriving provider market and skilled and motivated workforce; and effective partnership working – not just with the NHS, but with housing, and the voluntary and community sector, for instance.

This is about being better, not aspiring to be better, and we know councils can deliver.

There is no interest in government simply rearticulating the social care problem; we – and countless others – have done that. Now is the time for answers.

The current Government and its ministers have a unique opportunity to start this process, but politicians on all sides are just
as responsible for bringing about the change we need.

The LGA works on such a basis of cross-party cooperation. Now, our national politicians must do the same.

Recommendations to government

OBJECTIVE ONE: stabilise and sustain current provision in the short term (2018-19), and protect the known potential of councils.

RECOMMENDATIONS:

  • The Government must urgently inject genuinely new national investment to close the core social care funding gap that builds to £3.56 billion by 2024/25. This must include additional investment to that announced in the 2018 Budget to help address serious provider market stability concerns in 2019/20.
  • The Government should prioritise investment in prevention, community and primary health services when it comes to the £20.5 billion additional expenditure for the NHS.
  • The Government should implement a new ‘duty to cooperate’, requiring the NHS, and in particular sustainability and transformation partnerships,
    to engage with health and wellbeing boards as part of developing local
    plans to reshape and integrate health and care services that are genuinely locally agreed.
  • Through its Mandate to NHS England, the Government should ensure the NHS takes decisions based on the needs of local communities as a whole and public spending as a whole.

OBJECTIVE TWO: find a long-term solution that harnesses the known potential of councils to create a better social care and support system.

RECOMMENDATIONS:

  • The Government should invest significant new funding to close the funding gap facing adult social care that builds to £3.56 billion by 2024/25; and ensure that all older and working age people who need care and support are able to access it.
  • Where additional funding is invested in adult social care, this should be made available with as few conditions as possible so local areas have discretion to prioritise the most pressing local issues.
  • The Government should reverse the cuts of £600 million to the public health budget between 2015 and 2020.
  • As part of its 2019 Spending Review, the Government should consider wellbeing in the round, recognising the contribution that different council services, and those coordinated by other public sector and voluntary sector organisations that councils commission, make to wellbeing.
  • The Government should convene a core working group from across the sector, with people with lived experience at its heart, to develop a national campaign that seeks to raise awareness of what adult social care and support is, why it matters in its own right and what it could, and should, be with the right funding and investment. This should be genuinely co-produced, with government acting as a convenor.
  • The campaign should be clear about the local dimension of social care and support. It should strike the right balance between embracing the value of this local dimension while also being clear about the national framework in which social care and support sits.
  • The Government should only implement its care cost cap and asset protection floor proposals if they are part of a wider set of reforms that secure the
    long-term sustainability of adult social care and support as a whole.
  • In consulting on the shape of, and sustainable funding for, social care through its Green Paper, the Government should make the case for increases in income tax and/or national insurance and/or a social care premium.
  • Building on the campaign to raise awareness of social care and its value (see above), the Government should make the case for national tax rises or other sustainable, long-term solutions and consult on clear propositions which explain the various options for how sufficient funding for social care and support could be raised nationally. The Government must set out how such increases would relate to the wider social care and local government funding system. It should also be clear about how nationally raised increases for social care would relate to nationally raised increases for the NHS.
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