MPs say social care solution is needed - Should we have compulsory social insurance?
PUBLISHED: 08:24 31 March 2017 | UPDATED: 08:24 31 March 2017
A cross-party select committee of MPs has published a damning report into social care. Political Editor Annabelle Dickson looks at what the report found and some of the solutions being put forward.
Compulsory social insurance and the redirection of pensioner benefits are among a raft of measures which should be looked at to pay for social care, a cross-party group of MPs has said as they delivered a damning verdict on the state of the country’s social care system.
The major Commons Communities and Local Government Committee report said the financial situation is now “very seriously” impacting on the quality and quantity of adult social care provision.
Norfolk has seen a reduction in the overall quality of care, with less residential care providers (59.6pc) achieving Good CQC inspection ratings compared to the average for England (68.1pc), according to evidence submitted to the committee last year.
Suffolk County Council leader Colin Noble told the select committee last year that Suffolk had not increased the fees paid to providers for four or five years.
MPs issued a call for a cross-party review after finding a lack of resources had led councils to increasingly take a “price first, quality second” approach in their commissioning of social care.
The committee examined 200 submissions and held nine evidence sessions, including with leading Norfolk and Suffolk council figures,
Reacting to the report, Dennis Bacon, chairman of Norfolk’s independent care association, warned things were “really bad and they are going to get worse”.
He said the structure of social care was not fit for purpose with significant cultural, morale and workforce problems.
He echoed the concerns raised in the MPs’ report that people privately funding their care were “cross-subsidising the system”. But he said the whole system would collapse without the private subsidy.
“If you are in an area that is relatively impoverished and there are not those private fee payers it is much worse. It has kept things going. But is it fair and is it sustainable, I think the answer to both those questions is no?,” he added.
Conservative chairman of the adult social care committee on Norfolk County Council Bill Borrett said the council had been at the forefront of trying to get the best value for money.
He acknowledged that margins in the private care sector would have narrowed and that care providers were handing back contracts.
While he welcomed the extra money for Norfolk in this month’s budget, he said there needed to be a “step change” in funding if the social care system was to meet the national standards.
“I think as a country we need to decide what this service is going to look like. It is beyond the paygrade of Norfolk on its own.
“We do need to have a national debate as the figures are going to be getting worse into the future. As people are living longer it does make social care more expensive,” he added.
MPs suggested in their report that the government should consider ring-fencing levies from income tax, or creating a compulsory new social insurance scheme, to cover increasing costs.
But they said all options should be looked at, including redirecting some of the resources that now go into age-related expenditure such as funding for the triple lock pension guarantee, winter fuel allowance and free prescriptions.
The committee said funding levels meant councils were in “panic mode”, providing help to fewer people, and that the deterioration in overall care quality was set to continue.
North Norfolk MP Norman Lamb MP, pictured right, a former health minister, said the report confirmed there was a “real crisis in social care”.
“The Chancellor has promised an additional £2bn for social care over the next three years, but as the report makes clear, this falls well short of the amount required to close the social care funding gap. Ultimately, we must bite the bullet and consider paying more tax to provide social care fit for the 21st century,” he said.
North Norfolk-based Stephen Burke, pictured below, director of United for All Ages and the Good Care Guide, said a planned Green Paper expected later this year would provide an opportunity for the government to come up with a vision for care and support for older and disabled people. “We need a care system that is fair, simpler and sustainable. That will require substantially more funding,” he said.
Committee chairman Clive Betts said: “A long-term fix, working on a cross-party basis and involving the public and social care sector, is urgently necessary.”
High staff vacancy and turnover rates are causing severe challenges for the care sector.
The committee said the workforce was “essential to quality of care”.
Low pay not commensurate with the level of work involved, low status, poor terms and conditions, and lack of training opportunities and career progression were leading to the staff shortages.
The committee warned that the non-payment of the national minimum wage was “widespread” as a result of providers failing to pay care workers for their travel time, travel costs and ‘sleep in’ shifts.
“When commissioning care, councils must ensure that providers pay enough to comply with the national minimum wage and to cover care workers’ travel time and costs and ‘sleep ins’. Contracts between councils and providers should stipulate this and councils should regularly monitor compliance,” the report concluded.
Expectations about social care need to be reset and personal responsibility promoted, Norfolk County Council said in evidence to the select committee.
The county warned that without “significant reform” social care in Norfolk was “not sustainable”.
The submission last August, which helped shape the report, also said there should be incentives for suitable housing developments so more people could be cared for at home.
The authority said this was “critical” if councils were to be able to provide a “robust safety net for the most vulnerable people”. It also agreed with the government for a need to create a national training initiative to increase the status of the care worker.
Systemic changes were also needed to remove “perverse incentives” between health and local authorities, the evidence said. Norfolk County Council also called for large scale upfront investment to shift resources from acute settings.