Social care funding: New ministers, new legislation, same problems

The financing of social care for an ageing population has become something of a political saga of late, with the latest revelation alleged by The Daily Telegraph being that the now former Health Secretary Andrew Lansley clashed with Chancellor George Osborne over plans to means-test adults with home care needs and use the savings to finance the cap on long-term care funding.

The departed Care Services Minister, Paul Burstow, had already taken a swipe at the Chancellor when, writing in the Telegraph, he accused the Treasury of “kicking the can down the road”. According to what the newspaper calls ‘well-placed sources’, Osborne had asked Lansley “Why are you robbing Peter to pay Paul?” and left the Health Minister “extremely angry”.

The Prime Minister has since taken the decision to replace Andrew Lansley with former Culture Secretary Jeremy Hunt, despite the minister being a figure of controversy in his handling of the BSkyB takeover.

Chief executive at independent think-tank The King’s Fund, Professor Chris Ham, calls upon the new minister to recognise the long-term challenges the care sector faces, commenting:

“Jeremy Hunt takes up his post with the NHS performing well after years of investment and reform. However, fundamental changes in the way care is delivered are needed if the NHS is to respond to the demands of an ageing population, changing burden of disease and rising patient expectations.

“The new Secretary of State must show political leadership by supporting the case for radical transformation in the delivery of care. Although funding pressures on the NHS and social care are an immediate and pressing concern, he must focus on addressing the longer term challenges and ensure change benefits patients.”

Hunt is joined in the position by Liberal Democrat Norman Lamb, who replaces Paul Burstow as Care Services Minister, and has this week announced the launch of Healthwatch England. Pledged as part of the Government’s NHS White Paper on reforming the NHS, this new independent consumer champion is intended to reach out to health and social care service users whose voices have so far gone unheard.

On the consumer champion’s role, Lamb says: “We want to put people at the heart of our health and care services and Healthwatch England will play a vital part in these plans. It will make sure that people have a stronger voice and greater influence, through the experiences they share about their care, to drive improvements.”

Anna Bradley, who has been announced as chair of Healthwatch England, said: “Our job is to argue for what is in the interest of those who use services. Health and social care can be a complex world to understand, however our starting point is simple: it’s about people – their experiences, and needs.

“We will actively seek views from all sections of the community to build a national picture of what matters most to local people and to make sure their views and experiences are really listened to, analysed and acted upon. Better health and social care services has to be the result.”

Another announcement from a new minister this week, which will affect the practice of older people’s care, comes from Equalities Minister Helen Grant. The minister has confirmed that current legislation outlawing ageism in the workplace will now be extended to apply to public services, with the aim of impacting on accounts of older people being treated inhumanely.

Together with the legislation, a new helpline will also be set up to help those who feel they have been discriminated against. Helen Grant explains: “This sort of prejudice has no place in modern society and it is right that we introduce legislation that will protect people from unfair treatment.

“Not only are we providing protection against age discrimination, but we have been careful to ensure that the law strikes the right balance between protecting older people and allowing business to make sensible decisions.”

The Labour Party have not been silent on the issue of social care this week either, with Shadow Health Secretary Andy Burnham announcing his support, to the party conference in Manchester, for the full integration of health and social care budgets.

In response, Professor Chris Ham of The King’s Fund, points out that Burnham’s plans for 2015 will still leave the sector asking the same questions now being asked of the Coalition:

“Andy Burnham has outlined a vision for the future of health and social care which accentuates the differences between the Labour Party and the government on the NHS. He is right to stress the need for fundamental change in health and social care services.

“This includes moving care closer to people’s homes and re-thinking the role of hospitals which must change to improve the quality of specialist services and better meet the needs of older patients. We also welcome his emphasis on delivering integrated care – the challenge now is to move integrated care from the policy arena and make it happen across the country at scale and pace.

“However, while the long term vision is ambitious, the details of Labour’s plans are sketchy. A number of questions will need to be answered in the policy review announced. For example, it is not clear how local authorities could take on the role of commissioning health care without further structural upheaval. And despite the Shadow Chancellor’s pledge earlier in the week, it is not clear how Labour would ensure adequate funding for social care.”

Problems with inadequate funding are intensified by a funding shortfall caused by public sector cuts, according to research from Bupa. The report ‘Bridging the Gap’ estimates the current shortfall to have risen by £26m in 12 months, now standing at £892m in total, reflecting the gap between the true costs of care and the fees paid by local authorities.

Bupa UK director Oliver Thomas comments: “Central Government budget cuts means many councils can’t afford to pay a sufficient weekly fee to operators to care for some of the most frail and elderly people in our society. Some providers simply will not be able to deliver the quality of care that we should all be able to expect.

“Fixing social care should be top of Jeremy Hunt’s in-tray. The Government must recognise the urgency of the funding shortfall and allocate money to help councils pay the true cost of care now. The sector can’t wait for the next Spending Review, which could be up to two years away, for politicians to make a decision on funding.”

Images courtesy of Conservative Party, Liberal Democrat and Labour Party Photostreams