MPs call for £7bn social care funding increase as “starting point” for reform
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4090 (Published 22 October 2020) Cite this as: BMJ 2020;371:m4090
MPs have urged the UK government to make an urgent and sustained investment in social care to resolve a funding crisis that has been exacerbated by the covid-19 pandemic.
In a report published on 22 October,1 the Commons Health and Social Care Committee warned that some care providers were at risk of financial collapse and that the sector required an extra £7bn (€7.72bn; $9.16bn) a year by 2023-24 as “a starting point” that would help it to meet demographic and wage pressures.
But the full cost of tackling the growing unmet need and improving access to care was likely to be tens of billions of pounds, the committee said. It called on ministers to put forward a long term reform package before the end of this financial year and to publish a 10 year plan for social care, as it has done for the NHS. “The two systems are increasingly linked, and it makes no sense to put in place long term plans for one without the other,” it said.
The MPs recognised that this meant asking for substantial increases at a time of severe financial pressure but said that “the gravity of the crisis now facing the social care sector requires a bold response.”
Lifetime cap
The committee chair, Jeremy Hunt, said, “The pandemic has held up in lights the brilliant and brave work done by the social care workforce—but the real ‘thank you’ they want is not a weekly clap but a long term plan for the crisis in their sector.
“To address wider issues the sector needs a 10 year plan and a people plan just like the NHS. Without such a plan, words about parity of esteem will be hollow. We owe it to both the staff and families devastated by loss to make this a moment of real change.”
The report supports the introduction of a lifetime cap of £46 000 on care costs—a policy originally proposed by the Dilnot Commission—and endorses further consideration of free personal care. It says that the current means tested social care funding system is unfair, confusing, demeaning, and “frightening for the most vulnerable people in our society, and their families.”
The current system also perpetuates “a profound unfairness” because basic care is charged for certain types of conditions and not for others, the report adds. It gives the example that if people have dementia or motor neurone disease they receive no free care, but if they have cancer they receive free care.
The report also calls for action to improve the pay and recognition given to social care workers to ensure parity with NHS staff, as well as a clear career path more effectively aligned with the health service. Transitional arrangements should be put in place to enable the recruitment of social care workers from overseas for as long as necessary, it advises.