In the immediate future. what will the impact of the levy be for adult social care?
Absolutely nothing! Sadly, I don’t think it will have any impact on the adult social care sector because the way it has been muted we are looking at this money becoming available in the future.
And actually for the social care sector that means absolutely nothing. We haven’t got time. We need something that is sustainable right now that will support the sector.
So there is absolutely no point telling us, ‘there is money for you in the future’, when we are already chronically understaffed and the current climate when you look at cost of living, when you look at energy costs, when you look at the pitiful increases that are being promised by local authorities to providers it just doesn’t help the adult social care sector become a sustainable option.
So on reflection, is this levy really the right policy at the right time, or should the focus have been solving more immediate issues such as workforce shortages?
The levy may be a long term strategy, but in the short term we need to recognise two decades of neglect of social care, something which has become much more chronic over the last ten years or so. The evidence has been produced time and time again. So this is not about trying to see what is going wrong, this is about fixing it. We have no need to rehearse what we already know.
That time has passed and the pandemic has crystallised the fragility of the sector in such a way that it has impoverished it further. The impact is now something that we have been saying for years and years in that the impact is now being felt by the NHS as well.
As a result, rather than feeding the root of the tree – truly trying to get to the heart of the problem – we are trying to just pick the apples and go for the NHS. The thinking is almost ‘the NHS is suffering because social care isn’t sustainable, so let’s fix the NHS first and then we will concentrate on social care.’ It makes absolutely no sense at all.
Do you think that £5.4 billion over 3 years for the sector is enough?
It’s not going to be enough. We have either got to look at this and decide what it is we can and cannot provide anymore or we have got to fund it properly.
You can’t keep raising the bar, raising the expectations of a public that feel social care is properly funded when the reality is that it is not funded. You can’t raise the expectation to hotel-like accommodation with a regulator expecting the best – which is what we want to provide – and then choose not to fund it.
And it is a choice. I think it is really important to say, it is a choice that government has made not to fund it properly.
They have the means, the wherewithal and the evidence to do it. But what they have chosen to do is not to go down that route.
Is there an alternative measure to the levy that you feel would have a greater impact on funding for the sector?
We understand that this money has to come from somewhere and the route they have chosen is national insurance. But is that the right route?
It would be interesting to know what is raised through national insurance by social care itself, by our employees and our businesses. Is that the sum total of what is coming back to us because that just seems madness? We are potentially paying for our own funding.
Income tax might have been better, but I’m not sitting in Number 11. The important thing is that we recognise the money has been arranged somehow and this is the way that it is going to be raised. The choice now is how it is distributed.
We understand the NHS needs to be able to reduce waiting lists, along with other priorities. But there are two questions that need to be asked: is the NHS being run in the most effective way that it could be? And what if social care had been at the heart of the initial stages of this funding?
This isn’t about fixing social care; it’s about stabilising the NHS. That is the reality. We are stabilising the NHS and then we are going to look at how we can support social care to support the NHS. I don’t have a problem with that because we always have seen ourselves as a sector that can support the NHS so that they can deal with required acute care.
But it currently costs around £2000 per week to support a hospital resident who could be in a care setting at a cost of £600 per week. Think of the savings that could be made if you paid the social care sector an even £1000 to take those thousands of people sitting in NHS hospitals that don’t need to be there.
What have you have heard from the providers you represent regarding the levy?
The vast majority of people that we talk to about the levy (we represent small to medium sized providers) shrug their shoulders because they don’t expect to see it.
If this is something for the medium to long term a lot of providers are of the opinion that it would be too late.
We’ve got a staffing shortage right now. The virus is still out there. We’ve got no funding to support us to pay people when they are isolating. That has all been stopped and providers are expected to pay for that out of what is already an underfunded team. So I think there is a bit of shrugging the shoulders and thinking ‘what does this actually mean for us’. This is at the same time as the fair funding for care discussion that is going on, the involvement of private and local authority providers in arranging care, lots of things that are going to have a huge impact on the sector.
