Future proofing social care funding

Now the dust has begun to settle on the snap election result, we can weigh up the true importance of social care in current government policy. The profile of social care was much higher in this last election that it has been in recent memory. This was of course helped by the slightly haphazard way it was included in a certain party’s manifesto; if nothing else at least it raised the level of debate and enabled social care voices to be heard louder than than those clamouring for NHS funding. The potential outcome of a review and an autumn Green Paper is probably the best that could have been hoped for. It was however, a noisy conversation, not made any quieter by the appalling terrorist attacks and the horrific Grenfell Tower fire, with understandable debate on increased funding for other public sector services. Our national infrastructure has never felt so fragile.

But we must not let this opportunity go and we must continue to shout in support of social care, as the challenges and needs are not going away. Recruitment continues to be a metaphorical Everest in Oxfordshire, a situation facing every single sector with more players entering the market with the impending opening on 24 October of the Westgate Centre in Oxford. The cavalry in terms of much needed housing will take up to 20 years to come on stream and, even if it passes all the necessary checks and balances that local and national government requires, the resources to build substantial amounts of new housing will surely be restricted by the amount of labour available post-Brexit. And we don’t know if the housing will be affordable, or whether the status of care workers will be described as key workers like teachers, NHS workers, police and fire staff.

So it is with interest that we read the Reform Thinktank‘s paper on pre-funding social care. This paper does not pull punches and sets out the real disparity between young and old generations and the challenges that Millennials and those born since will face financially. The cost of publicly funded social care is due to double in the next 50 years to £40m or 2% of GDP. Whilst we wait for government manifesto promises to be dropped completely, or resurrected with a less shabby label than dementia tax, Reform suggest a more basic funding of social care. Starting from a point where most people will not be able to afford the care they need for the length of time they need it, it argues for pre-funding social care with a suggested 2.55% Later Life Care Fund; in short a mini-National Insurance with employer and employee contribution aimed specifically at social care. However, unlike National Insurance, contributions would be taken between the ages of 40-65 to offset the risk of setting contributions at the wrong level. In theory this is sound. Most people are better off and at peak earning during these years with children either more independent or having left home altogether.

There are, however, substantial questions to be asked about the management of a public pool of funding intended for a widespread need over long periods of time, not only in the light of increasing NHS pressures, but also how those with early life social care conditions, such as a learning disability, or acquired brain injury, might be supported if they haven’t paid in. And how will public opinion form about those whose current lifestyles do not encourage good health (see Radio 4’s scary Dystopian vision about rationing medicines)?

Finally, not least, is whether such a model would attract public support with a prevailing wind of a low-taxation economy. But given the current stagnation or actual decrease in real wages, a model which moves the funding demands from all-at-once to gradual contributions creating a public pool is an appealing one. Time will tell whether the market, both social care and insurance, will see this proposal in favourable light.

Reform’s paper is an excellent contribution and much-needed to widen the discussion. Let the debate begin on how we future proof social care.