Social care: Boris Johnson announces first steps to reform

As the Prime Minister announces plans to reform health and social care in the UK, we look at what to expect and charities reveal their concerns.

Earlier today (7 September), Boris Johnsons set out plans for more health and social care funding in the UK, where this funding will come from and how it will be used.

Funding

As part of the new plans, there will be a 1.25% increase to National Insurance (NI) starting from April 2022, the beginning of the next tax year. This will be paired with tax on share dividends and will be a separate tax on earned income from 2023.

The move, which breaks a tory manifesto commitment, will raise nearly £36billion over the next three years for frontline services.

The announcement also included plans to cap the amount individuals can spend on their care, with anything over this limit funded by the taxpayer. From October 2023, anyone starting care in England will spend no more than £86,000 on care over their lifetime, and anyone of assets less than £20,000 will have their care costs fully covered by the state. Those with assets above the lower limit but less than £100,000 will have their care costs subsidised.

While the countries that make up the rest of the UK have their own social care policies, they will benefit from £2.2billion a year, 15 per cent more than they will contribute through the new NI levy.

Quality

The plans come after years of campaigning from charities, families and organisations, and commitments made in the conservative manifesto ahead of the general election in 2019.

They aim to protect people from losing everything to pay for the cost of care while also aiming to get the National Health Service (NHS) back on its feet in the wake of the coronavirus pandemic. The update revealed plans to integrate the health and social care systems with a white paper expected later this year.

The dedicated money will also go towards funding nurses, tackling the current backlog in scans, appointments and treatments due to the pandemic, and creating a higher quality health and social care system.

Response

While aspects of the announcement have been welcomed by charities, there is also concerns around whether it is enough. Read the response of organisations:

Ruth Owen OBE, CEO of Leonard Cheshire, says: “The plans announced today are a step forward. They in part address decades of failure by different Governments to act on social care reform. 

“Not having quality social care, tailored to need, denies disabled people the opportunity to earn a living, learn or socialise. These are fundamental rights. Additional funds are desperately required but the changes necessary are wider than that. Deep rooted reform of social care is necessary so individual needs are better met, and in more innovative ways. We also need to work on making social care more attractive as a career to help tackle growing recruitment issues.  

“There’s no denying the pressures right now. An extra £12bn was estimated to be needed for social care in England alone this year. So although this is a step in the right direction, additional money is urgently needed for the here and now.”

Edel Harris, chief executive of the learning disability charity Mencap, says: “The social care crisis has been a contentious issue for decades, and we welcome the government’s brave move to try to tackle it. While there are some welcome changes in today’s announcement, it doesn’t address the short-term funding crisis and we can’t see how the proposed cap on care costs will benefit people with a learning disability. 

“Today’s announcement won’t be enough to fix the crisis that is happening right now. People who need care are missing out, others are having their support cut and some are being asked to pay towards their care which they simply can’t afford.

“Every day, carers are leaving the profession because they don’t get paid enough for the skilled work they do. We’ve seen nothing to reassure us that hard-working care workers will get a much-deserved pay rise, even though providers like ourselves are losing staff to become delivery drivers and supermarket workers. The risks to people and their families in need of care is real if carers continue to leave the sector at the current rate. 

“Reforming social care is the key to rebuilding after COVID-19. We want a social care system that meets the needs of the people who need care and those who provide it – a system fit for the 21st century.”

Tim Nicholls, head of policy at the National Autistic Society says: “This is a significant increase in funding for social care, which we, autistic people and families have long been calling for. It’s a once-in-a-generation opportunity to fix the system, but we’re really worried that we will need to wait three years to see all the funding for social care in place. The system is in crisis now. 

“Our research suggests that two in three autistic adults don’t get the support they need, for instance to do things like wash, manage money or get out of the house. We continue to hear awful stories of people becoming isolated, developing mental health problems and finding themselves in crisis. The pandemic has only made things worse.   

“We urge the Chancellor to invest what’s needed now in social care, provide local councils with the funding they need and properly fund the autism strategy beyond the next year. Autistic people can’t wait any longer.”

Richard Kramer, chief executive at disability charity Sense, says: “Once again, the social care system is treated as the ‘Cinderella’ service to the NHS.

“After years of promised reform, and a pandemic that has brought the social care system down to its knees, we can’t help but feel disappointed by the announcement.

“We welcome the immediate investment into social care, but we don’t have confidence that this is the long-term, sustainable and sufficient funding plan that was promised. Will the money really find its way back into social care after 2025?  We need a commitment from Government that this money will be ring-fenced, or we will never find our way out of this crisis.

We must ensure the care needs of the elderly and the disabled are addressed, and the cash doesn’t just end up filling other gaps within the wider health care system. 

“This must be the first step in ensuring disabled people and those in vulnerable situations, many of whom have had their services cut over the last 18-months, are no longer forgotten and receive the right care and support.”

Phillip Anderson, head of policy at the MS Society, says: “Successive governments have taken decades to come up with a plan for social care. As the wait has dragged on millions of people, including many with MS, have been forced to go without the vital care and support they need. Sadly, today’s announcement has not been worth the wait. 

“Protection from catastrophic care costs and expanded financial support for those with fewer assets are both meaningful and welcome improvements. However, fundamentally this plan focuses on those currently in the care system, overlooking at least 1.6 million people with unmet care needs, including one in three people affected by MS. It is also very difficult to see how this funding could tackle huge issues such as quality of care, workforce, and informal carer support, without taking much-needed funds back out of the NHS.”

Professor Martin Green OBE, chief executive of Care England, says: “We have been waiting for a very long time for any concrete plans on the long term sustainability of adult social care reform and as such we welcome the Prime Minister’s announcement today.  We want to go through the plans carefully and it is our hope that social care will be rewarded and recognised rather than playing second fiddle to the NHS.  It is essential that money reaches the frontline.”

“The sector needs help now especially after the many challenges that became even more acute during the pandemic.  We hope these plans will comprehensively address the issues across the whole adult social care sector, including younger adults with learning disabilities and autism. Recruitment and retention of workforce, our best resource, is the most urgent issue at present and it is vital that any long term plans can be brought into play alongside immediate measures. Care workers are everyday heroes and have highlighted their value throughout the pandemic and need to be rewarded and recognised appropriately”.

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