public health and social care

We must not compromise

Ahead of the government’s green paper, Margaret Willcox OBE, president of the Association of Directors of Adult Social Services, says we must find a solution to the social care market that applies to all adults equally.

As we emerge from a winter that has seen a greater pressure on health and social care than any previous ones, what are we hoping to see in the summer? A green paper.

For the best part of 70 years, we have had a social care system based on the original welfare state. During the past 20 years, there have been dozens of reviews and reports that have identified the need for sustainable funding for those people in our country who need care and support. The current care market is fragile, with a lack of available workforce at the centre of those concerns. The reputation of social care is damaged, and those who work in it don’t have the status or admiration afforded to our colleagues in health.

I believe we need an open and honest conversation with the public about what model of social care they want for themselves and their family and how should it be resourced. Whilst the current system of means-testing is long-established, most people do not realise that social care is a service that you have to be eligible for and may be charged. From the outside, much of what we do looks like healthcare, and we all know that the NHS is an entitlement and free at the point of delivery. It’s confusing. Every time a researcher asks if people would pay more tax for the NHS, the answer is yes. Would they pay more for social care too? We don’t know.

We’re in our eighth year of austerity and we’re still here, supporting 1.1 million people every day of the week. In this precarious market, I have witnessed care staff braving all weathers and long hours to ensure the people they are responsible for are treated with dignity, despite being paid less for every hour than they could earn in their local supermarket. I believe the public can visualise what they do when they consider someone who is elderly and frail that needs personal care and help with things they used to be able to do for themselves. I think it’s more difficult for them to conceptualise the role of social care with a young adult who has learning disabilities and wants to get a job, or someone in a mental health crisis who is finding life difficult to manage.

The green paper is due to address the future of social care for older people. There’s a parallel piece of work underway to consider the needs of working-age adults. What we definitely don’t want is another transition point. It’s problematic enough moving from children’s services to adults, especially as the relevant legislation is so different. Any proposal that inserts another hurdle because of a birthday must be resisted.

We must have a solution that applies to all adults – one that is easy to describe and understand, that puts the dignity of people first and acknowledges the skill and compassion of the workforce. It has to be affordable for the population and equitable for those who need to use it. We should not compromise on quality or ambition.

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W: www.adass.org.uk