The Conservative manifesto promises to fully enact the delayed reforms to social care, including the ‘cap’ on lifetime costs. Do you believe this policy alone is sufficient to deal with the challenges for people seeking to access care for themselves or their loved ones?
No. Not at all. It’s a partial and very much delayed response to only part of the challenges of providing social care on an equal and just basis. First, this commitment has been delayed for so long that the cap itself needs to be revisited.
A policy for social care has to respond to the pattern of needs and resources across the whole sector: the workforce is, as we know, absolutely critical, and that includes pay and professional standards and how care is provided at home.
That also involves bringing together health and housing policy, building and adapting homes for people who need support at home, and ensuring that health and social care are working more closely now that the Integrated Care Boards are in place.
The Liberal Democrats and Greens have both pledged to implement Scottish-style free personal care in England and Wales in their platforms. Is Scotland’s approach and model one that can effectively meet England’s care needs in the long term?
I think this is a counsel of perfection. You cannot make easy or credible promises based on comparisons between the small population and the different priorities of Scotland with the vast and complex communities of England and Wales.
Moreover, it is not at all clear the price that other parts of the health and social care services in Scotland have paid for free personal social care. Clearly, there must be trade-offs because we have to deal with the realities of financing the complex range of needs that have to be met.
The priority should be that those most vulnerable and with the fewest resources should not be penalised because a more generous policy leaves them at particular risk. All these factors and choices have to be weighed against what is essential, just and affordable.
The Government has implemented a ban on care workers' dependants which has already led to an 83 per cent drop in visas in March 2024 compared to the previous year. Given the sector faces around 150,000 vacancies, can this be sustained without exacerbating workforce shortages?
Policy for the social care workforce has swung wildly around recently, and now there is even more instability created in the system. We cannot build a workforce policy that relies on immigration, which, predictably, has brought its own complications and unfairness.
We are fortunate we can draw on skilled and compassionate overseas workers, but it has to be properly thought through in the context of a proper pay and career structure for UK workers.
In the short and long term, we need a guaranteed offer for social care workers based on decent pay and dignity and a progressive career structure, which will mean they can commit to it in the long term.
Labour has retained its commitment to a Fair Payment Agreement in the sector. Is such a policy a suitable means of improving the incentives for people to pursue a career in social care, or could it force impossible costs onto local authorities already near bankruptcy?
I think that this is the first and absolutely critical step in building a resilient and sustainable care force for the future. However, it will have to be appropriately grounded in realistic expectations about the costs and evidence of what will work best and fairly.
The experience of local authorities and their knowledge of how to retain and recruit care workers will be essential to getting it right. The financial requirements and impacts have to be transparently worked through, and local authorities and care workers' organisations are critical to this.
However, the point is that in the long term, it can save costs as a professional care force will enable better planning of services without the need for agency work and constant improvisation.
It will be a game changer in the way care workers are seen as skilled professionals, and it will be the first step in creating a profession people are proud to work for and can afford to work in.
Finally, the recent scandal of unpaid carers being forced to pay fines for breaches in the Carer’s Allowance has shocked the nation. How should the next Government go about incentivising and supporting the millions of unpaid carers upon which the sector is dependent?
This is indeed a scandal because we know that while the system was alert to where unpaid carers had gone beyond the legal limits, it did not alert the people involved and allowed them to build up outstanding debts to be repaid.
This should never have happened, and we need reassurance that it no longer will occur, along with acknowledging that such debts should rightly be written off. Unpaid carers need an advocate and a champion - a Commissioner who will give them additional profile and support, more provision to identify them when they come into contact with the health service and social services, and a more straightforward pathway for support.
Moreover, the Carer’s Allowance needs to be revisited, and hours of work should be made more flexible. In short, they need more support, not more pressure, given what they give back not just to their families or friends for whom they care but to society as a whole.