Thursday, 3 May 2012

Let's Get Social Care Out of the Darkened Corner


The Health & Social Care Act 2008 received Royal Assent on 22nd July 2008 but the bulk of the provisions relating to social care where not put in force until 1st October 2010. So, in essence, there was a two year gap between the final stage of the Parliament and the implementation of the Act. Of course, this is just the end of the process, a bill has to travel through the parliamentary process. For example, the controversial Health & Social Care Act 2012 had its first reading in Parliament on 19 Jan 2011 and received Royal Assent on 27 Mar 2012, probably an extreme example but it highlights the length the process can take.

What’s the point of that little tour of the Parliamentary process?

Simply speaking, the current Government has three years, at the most, left and unless they take action soon on social care there will not be any changes to the current system while this Government is in power, if they do, eventually, legislate it will be left to the next Government, whoever they are, to implement any changes made. And, more importantly, it could be close to three years to see any substantive change in the social care system (always assuming the Government put any substantive changes in a bill!).

To most of us in the sector such prevarication on social care is not unusual and not just limited to the Government in power at present. I won’t repeat the gist of my previous blog (Politicians Seem Clueless About Social Care) but suggest what we need is a radical approach to reforming social care at the very top.

When Ivan Lewis was named care minister in 2006 he promised a radical review of social care, unfortunately that never happened and the first announcement of a consultation on social care came only once Alan Johnson took over the role of Health Secretary from Patricia Hewitt a year later. This suggests that any real action on social care is decided by the senior minister who sits on the cabinet.

Obviously the Health Minister is generally more concerned about Health Care rather than Social Care as evidenced by this Governments pushing through the 2012 Act despite opposition from many health professional organisations. Social Care seems to occupy a tiny corner within the Department of Health thinking.

But why does social care sit in the Department of Health?

Social Care is not a minor area of public policy to be handily attached to what appears to be the most appropriate Ministry.

The number of people receiving local authority funded services in 2010/2011 was 1.6 million and this excludes people who pay for their own care and people deemed by social services as not having sufficient need level to qualify for support and who are cared for by unpaid family members etc., so true figure of those who may need social care services is considerably higher.

Skills for Care estimate that the social care workforce also numbers 1.6 million. So, at a minimum, 3.2 million people are involved in social care services. Add to this the fact that Skills for Care also “work closely with the 40,600 organisations that offer social care people who use services, carers and with other key stakeholdersand it is hard to see why social care does not get much more attention than say the Department of Culture, Media & Sport which has a Cabinet Minister in Charge.

It is also important to remember that social care is not just about health, although that may play a significant part in end of life care etc. the role of social care is to support and care for individuals in their day to day living and health remains the responsibility of health professionals. The public often only connect social care with elderly care but it goes beyond this and beyond the remit of health.

For adults below the age of 65 who need social care services much of the focus is on appropriate housing, employment opportunities and living independently. The latter of which is also a focus of social care for the elderly. Social care is about maintaining links with society and maintaining social well-being in addition to health well-being.

We need action on social care and we need political consensus rather than political paralysis. Let’s start by achieving consensus that social care should not sit in a darkened corner of the Department of Health and it deserves its own Ministry with its own Minister who sits on the Cabinet and has the opportunity to bring forward legislation but more importantly to show that Westminster is truly serious about working for the millions in the country who receive or are involved in delivering, social care services.