The Government should spend £8 billion immediately ‘to restore the quality of and access to adult social care in England to acceptable levels’, and then introduce free personal care, funded through general taxation, over a five-year period, says a House of Lords Economic Affairs Committee report, 'Social care funding: time to end a national scandal', published on 4 July.
The Committee’s chair, Lord Forsyth of Drumlean, said: “Social care is severely underfunded. More than a million adults who need social care aren't receiving it, family and friends are being put under greater pressure to provide unpaid care, and the care workforce continues to be underpaid and undervalued.
“The whole system is riddled with unfairness. Someone with dementia can pay hundreds of thousands of pounds for their care, while someone with cancer receives it free. Local authorities are increasingly expected to fund social care themselves, despite differences in local care demands and budgets. The reduction in social care funding has been greatest in the most deprived areas, and local authorities can’t afford to pay care providers a fair price, forcing providers to choose whether to market to those people who fund their own care or risk going bankrupt.
“The Government needs to spend £8 billion now to return quality and access in the system to an acceptable standard. Fixing unfairness is more complicated, but the Government has ducked the question for too long. It needs to publish a White Paper with clear proposals for change now. We think this should include the introduction of free personal care, ensuring that those with critical needs receive help with essential daily activities like washing, dressing, and cooking.
“Our recommendations will cost money, but social care should be a public spending priority. By 2023/24, the NHS funding will have increased by £20.5 billion per year – more than the entirety of local authority adult social care expenditure.”
The Committee says publicly funded social care support is ‘shrinking’, with funding £700 m down on 2010/11 in real terms, despite continuing increases in the numbers of people who need care. Over 400,000 people have ‘fallen out of the means test’, the Committee says, which has not increased with inflation since 2010. The Health Foundation and King’s Fund estimate that to return quality and access to levels observed in 2009/10, the Government would need to spend £8 bn.
The Committee says its proposal to bring in the entitlement for social care closer to the NHS by introducing free personal care is ‘simple, fair, and not much more expensive than other proposals for reform’. Under its plan, those in care homes would still pay for their accommodation and assistance ‘with less critical needs’ like housework or shopping. Those receiving care at home would not have to pay accommodation costs, ‘which may encourage care users to seek essential help with personal care early’. This model would cost £7 billion per year according to the Health Foundation and the King’s Fund, “only £2 billion more than the Government’s 2017 ‘cap and floor’ proposal.”