In recent months, the media has rightly focused on Dilnot’s proposals for how we reform the way we pay for care.
But alongside those reports, the nagging problem of the under-funding of social care more generally has been bubbling away in the background.
According to a recent report from London Councils, there will be a £907 million adult social care funding gap in the capital by 2018. And, although the extent of the gap can be – and is – disputed, it would be foolish of anyone to deny that we have a growing crisis on our hands.
Ultimately, it is clear that the under-funding of social care shunts people into more costly healthcare. As one person put it to me at a recent conference, “by ignoring social care you place all the burden onto the NHS until it reaches breaking point.” So if we don’t want to place any more pressure on the NHS, we must place social care at the forefront of our minds.
A 1997 report from the Audit Commission described the pressures in the social care system as a ‘vicious circle’, and not much has changed since then. As the number of people living with chronic illness grows, the number of hospital admissions rises and the demand for formal care increases. This in turn leads to ever more resources being spent on high cost crisis interventions at the expense of low cost preventative services that could have reduced the pressures in the first place.
Over a decade ago, the 2002 Wanless Review
discovered serious shortcomings in social care provision and funding arrangements. It was a damning critique on an unfair system which fails older people every year – sentiments that have not lost their sting or relevance years later.
It looks likely this criticism of an unfairly financed social care system will be fixed, with a forthcoming announcement from the Government on Dilnot expected shortly.
What hasn’t yet been answered is the question Derek Wanless posed on the need for the Government to better understand the financial interdependencies between health and care. He called for improved financial models and a review of social care funding – an exercise that is yet to get off the starting blocks.
Yes, the King’s Fund helpfully published the Wanless Social Care Review in 2006 () – but this kind of exercise must now be undertaken by the Treasury if it is to gain any traction inside Government.
Now is the time for action if we want to ensure a sustainable NHS, and social care system, for generations to come.
Paul Burstow MP is chair of the Joint Committee on the draft Care and Support Bill and a former Minister of State for Care Services.