New social care funding misses the point
Source: PSE Apr/May 17
Clive Betts MP, chair of the Communities and Local Government (CLG) Committee, reflects on the social care funding released in this year’s Spring Budget and the government’s much-anticipated Green Paper.
While it is welcome news that the chancellor has recognised that the struggling adult social care sector needs extra funding, it is highly likely that we will be having similar arguments about the crisis come next year, the chair of the CLG Committee has told PSE.
Speaking to us after the Spring Budget, where Philip Hammond announced a further £1bn for social care in 2017-18, Clive Betts said the funding falls well short of the £1.5bn his committee recommended was necessary to plug the gap in funding for the next year and provide adequate relief from the immediate pressures faced by local care services.
“We also said as a committee that there are so many different estimates of what the position is going forward, for the rest of the Parliament, that we thought the easiest and most objective way was to ask the National Audit Office (NAO) to do a review of what the position was and, very quickly, they could come up with a figure which we could then all agree on,” he explained.
“The government didn’t mention that. I think, just to pluck another billion pounds over two years, to say that’s enough, misses the point. The chancellor can’t be certain it is enough, he doesn’t have any credible evidence to back it. We could be back here in a year’s time having the same argument.”
While the committee accepted there needed to be a quick fix for this financial year, noted Betts, there was also a consensus that a little bit more reflection and analysis would have helped settle a longstanding argument.
Cross-party Green Paper
While at the despatch box, Hammond said “the government will set out its thinking on the options for the future financing of social care in a Green Paper later this year”.
Betts, whose committee completed its inquiry into adult social care as PSE went to press, recognised that for the longer term there needs to be a review. “We are pleased to see a Green Paper in the offing, although there is no clear timetable yet. We will certainly be asking questions about that,” he argued.
“We, as a committee, said, ideally, that looking for the long term we should get agreement on a cross-party basis. That is a cross-party committee saying, unanimously, that for the long term we need it on a cross-party basis. There is no mention of that, so far.
“Again, ideally, we ought to have the cross-party talks before we get to the Green Paper, but at the very least, we should have them after the Green Paper is produced.”
Discussing the evidence presented to his committee, Betts reflected: “No one has come forward and said: ‘this is how we are going to solve it’. What we have seen is that there are massive challenges. No one has given us evidence that it could all be funded by the public sector, and it will be all out of national taxation.”
He added that one thing most people want to see is a strong local element, with local accountability. However, how you put that together, while recognising the significant changes about the localisation of business rates that are also on the horizon, are issues that need to be reflected on.
“We have had lots of problems presented to us, but not a comprehensive solution. That is what the Green Paper should be looking at,” he stated. “One thing that the chancellor did say, in addition, was that he ruled out any change to a tax on people’s assets once they die.
“If you are going to do a complete and comprehensive review of the system, you don’t begin by ruling things out. You say we have to consider the options. I don’t think it is helpful to begin by ruling out something that could, eventually, be worth considering.”
Health and social care integration
Discussing health and social care integration, Betts stated that NHS England’s chief executive, Simon Stevens, told his committee that while it can bring benefits, “it is not going to solve the problem of social care funding in the long term”.
“It won’t solve it,” said Betts resolutely. “If anyone thinks all we have to do is get health and social care integrated and everything will be fine, they are missing the point. We are still going to have a continuing need for extra funding for social care, simply because of demographics.
“Pooling budgets is sometimes called joint commissioning, and there are different ways of doing it, but the one difficulty with all these things is that they tend to work until something goes wrong. And then everyone blames everyone else for what happened. You really have got to have clear lines of accountability and, of course, currently health and social care have very different accountability systems.
“Social care is accountable to, ultimately, elected councillors on the local authority. Health is accountable to the secretary of state. I don’t think government yet has a clear view of how that works. That is going to be a challenge for the future. The Manchester system is a halfway house towards it, but leaves some of those questions unanswered.”
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