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Wes Streeting right about one huge problem — if we don’t fix it, we aren’t civilised.uk

There are certain metrics by which one can judge whether or not a country qualifies as civilised.

Wes Streeting

Wes Streeting is right about one huge problem UK faces (Image: PA)

This week we heard the Health Secretary say you cannot solve the problems of the NHS without a stable social care system. I would like to nominate this as an early entry for 2025’s definition of a small mercy. Wes Streeting is right, of course. The perma-crisis in many emergency departments happens because patients cannot be moved out of A&E into medical wards. And this is because about one in seven of the beds on those wards is occupied by someone who ought to be in a care setting, not stuck in hospital. This in turn is because there are not enough home care workers or residential care home places.

If this recognition of a longterm social care crisis leads to effective action, it will be very welcome. But the social care sector is rightly wary, and a bit sceptical. Too often, the money given to the “health and care system” gets stuck inside the NHS, leaving social care as the Cinderella service, ignored and unprotected. The anger among social care providers has resulted in that most unusual phenomenon – a demo outside Parliament by the social care sector, under the banner of Providers Unite. As Chair of the Social Care Foundation, I took part to show support and can report that there has never been a more polite and well-ordered march and rally.

But this should not disguise the real anger and fear for the future that exists among the providers of social care services. The immediate cause is the imposition of higher national insurance charges on social care employers from April.

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Not only will they be paying a higher rate, but the wage level at which they must pay the tax has been drastically reduced, too, adding hugely to costs in an industry where there are many part-time workers. This extra cost will for some operators be the straw that breaks the camel’s back.

I fear that some care homes will close, shortages of home care workers will become worse, and therefore the lives of some of the most vulnerable people around, old and frail or disabled, will be made worse.

It is a grisly prospect – one which will cause anxiety in thousands of families. That is the immediate crisis. And it is a symptom of a longterm problem that successive governments have tried to address but have eventually shied away from.

That problem is, straightforwardly, that we are not prepared as a society to spend as much on social care as we need to if we want a decent, stable and humane system.

 

This underlying failure is the root of all the serious issues that social care needs to address. The sheer lack of capacity. The failure to adopt new technology so that everything runs more efficiently.

The lack of proper integration between the NHS and social care. These all need looking at urgently, but cannot be solved without more money.

That money can come either from the taxpayer, which means under-pressure working-age people being forced to stump up even more, or from individuals insuring themselves for care costs in later life.

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I believe it is possible to set up an insurance system along the lines of the private pension industry which would mean no one would have to sell their home to pay for care (although a proportion of housing wealth would, for many people, be used to buy the insurance policy). Whatever system we adopt, we ought to get on with it.

Sadly we are doing the opposite. Both major parties suffered electoral horrors when they proposed solutions to the crisis, with Labour being pilloried for a “death tax” in 2010 and the Conservatives for a “dementia tax” in 2017.

So I understand the politics of Wes Streeting setting up a commission under the excellent Louise Casey to look at the issue and giving her a three-year timescale.

However, those working in social care, and most importantly those receiving it, feel they cannot afford to wait three years for a solution. This ought to be a much bigger political issue.

In an ageing society, we cannot call ourselves civilised if we do not provide dignity for the frail, elderly or disabled. It makes me and many others angry that often, this does not happen. Therefore we are determined to keep social care near the top of the political agenda.

Damian Green is chair of the Social Care Foundation and a former MP and Minister

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