William Burns, Social Care Policy Advisor
On 29 July, the Chancellor revealed that the cap on personal care costs and changes to the capital limits in the adult social care financial assessment would no longer go ahead to mitigate a £22 billion black hole in public finances. It is important to make the system for paying for adult social care fairer, but CIPFA will always support decisions that lead to better public financial management. As we set out in our public statement, there are more urgent, existential challenges facing the social care system than charging for care and support.
The difficult reality is that the policy was underfunded, and local authorities were not prepared for implementation. As we explored in our recent publication, Managing rising demand for adult and children’s social care, demand for and spending on social care is rising in England. Over three quarters of local authority expenditure is directed towards adult and children’s social care, leaving little funding to cover other statutory duties. According to the ADASS Spring Survey, 72% of councils are relying on reserves to plug funding gaps. These facts make it clear that the government’s focus should be on strengthening the sector’s financial foundations to make the system resilient and ready for reform.
With the previous government’s charging reforms scrapped, the question now is how the Labour Government plans to address the challenges in social care. Stephen Kinnock, the Minister of State for Care, answered this question by reaffirming Labour’s commitment to creating a National Care Service (NCS). Labour commissioned the Fabian Society to produce a roadmap to an NCS, although the party never committed to any of the report’s recommendations. Instead, there were wooly words in the Labour manifesto about ‘build[ing] consensus for the longer-term reform needed to create a sustainable National Care Service’. There are also rumours swirling that the government will announce a new Royal Commission on Care — 25 years after the Royal Commission on Long Term Care for the Elderly in 1999. For Labour, it seems there is less grasping the nettle than kicking into the long grass. We do not need another commission, we need decisive action.
The SNP-led Scottish Government are also pursuing a policy of establishing an NCS. The aim is to have a functioning NCS by the end of the current parliamentary term in 2026. Stage 1 of the Bill passed through the Scottish Parliament in February 2024, and CIPFA is currently formulating its response to the consultation for Stage 2 of the Bill. This work will build on our previous NCS consultation response, in which we expressed concerns about the estimates contained within the Financial Memorandum and the risk of the loss of local decision making. Ultimately, it is CIPFA’s view that any programme of reform must result in improved outcomes for people who draw on care and support and represent value for the public pound. Under current proposals, it appears that there is a focus on structural change rather than improving the health and social care integration system within the current framework using existing legislation. If Labour are kicking the can down the road, then maybe the SNP are rearranging the deckchairs.
The road to reform has clearly been long and winding, and we still haven’t reached our destination yet. One thing is for certain — the Labour Government needs some get-up-and-go. There is no time for delay.