The social care system is at breaking point and needs reform

Hilary Evans is head of public affairs at Age UK

The past few months have been full of speculation about dissent and division between the coalition partners; on AV, on pensions and most recently on health. Today Age UK, as part of an alliance of health charities and think-tanks, has written to all three main party leaders calling on them to put aside their political differences and work together to reform social care.

It’s clear that the social care system in England is at breaking point and badly in need of reform. Earlier this week, Age UK launched our ‘Care in Crisis’ report (pdf), which outlines the flaws in the current care system.

The system simply isn’t meeting people’s needs. In England, of the two million older people with care needs, over 800,000 currently receive no support whatsoever from either public or private sector agencies.

Funding has increased only incrementally, 0.1 per cent per year in real terms since 2004, while local authority budget cuts mean that spending on older people’s care is due to plummet by £300 million over the next four years.

There are massive variations in the quality and quantity of care between different local authorities, and older service users receive less funding on average than younger ones. The system is failing to meet people’s basic needs and desperately needs to change.

There were opportunities to reform the social care system during Labour’s time in government which weren’t adequately seized. The Royal Commission on Long-Term Care, established six months into Blair’s first term and reporting in 1999, made a series of recommendations on care reform; including paying for personal care through general taxation according to need, establishing a National Care Commission to set benchmarks, monitor longitudinal trends and represent the interests of consumers, a national carer support package and a more transparent grant and expenditure allocation system.

The majority of the Commission’s recommendations were never implemented. Subsequent reform attempts were too little, too late. The Personal Care at Home Act was passed last April in ‘wash-up’ before the general election, but relies on a commencement order to take effect. The coalition government announced in November last year that it would not be commencing the Act – a symptom of the failure to achieve broad political consensus on the need for reform.

But change is on its way.

Last month saw the publication of the Law Commission’s review of adult social care law, which is proposing some significant changes to the legal entitlements and responsibilities accompanying social care provision.

Under the proposals, there would be a national framework for eligibility, which would stipulate basic minimum entitlements to services. Care users would be able to use direct payments to purchase residential care. There would be clear legislation on the role of social services in leading and coordinating the safeguarding of vulnerable adults, a topic which is currently left to guidance. There would also be more support for carers; local authorities would have a duty to assess carers’ needs, and also a duty (rather than a power at present) to meet them.

The Law Commission’s proposals on social care legislation will be combined with the Dilnot Commission’s upcoming proposals on social care funding and should form the basis of new legislation on adult social care reform in the next parliamentary session. Andrew Dilnot’s Commission on funding of care and support, is due to make its final recommendations at the beginning of July.

Early leaks have suggested that Dilnot may recommend a cap on lifetime care costs as the best way forward, which would mean individual care users paying no more than, for example £50,000. We will wait and see, but we’re clear that what we won’t see is a recommendation for free social care paid for from general taxation, owing to the financial and political costs of making such a decision. Thankfully, the Commission has recognised that increasing overall spending on social care is absolutely necessary to sustain and improve the care system.

So we’re urging all of the party leaders to get behind a serious shake-up of adult social care. The burden of further delay will be borne by the often frail and vulnerable older people who depend on care support.