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PAC: Green paper is not a ‘cure all’ for mounting social care pressures

The government should not be content with councils’ ability to simply meet the legal minimum for care provision, the Public Accounts Committee (PAC) has warned.

A report by the influential committee argued that the adult social care sector is underfunded, and that its workforce suffers from low pay, low esteem and high turnover of staff.

According to MPs, the care sector is in a “precarious state” but the Department of Health and Social Care (DHSC) has not yet explained how it intends to put in place a long-term, sustainable funding regime to meet the increasing demand for care.

Furthermore, the department is not clear on whether the ways that local authorities commission care, and the prices they pay providers, are contributing to the problems within the care workforce.

The committee also warned that Brexit is causing uncertainty over how the workforce will be sustained in the future, particularly in areas that are more reliant on non-UK workers, and that there is an urgent need to reverse the poor public image that care work has to boost recruitment and retention across the care sector.

The government has committed to addressing the growing pressures on the sector through the health and care workforce strategy and the delayed green paper on long-term funding of care for older adults, but PAC is concerned that DHSC sees the green paper as a “cure all” and underestimates the scale of the challenge.

The committee’s chair, Meg Hillier, said: “Adult social care needs sustainable funding and a stable workforce. The sector is scraping by and without an explicit, long-term plan backed by government it could soon be on its knees.”

Levels of unmet need are on the rise, she added, warning that short term funding fixes are “a road to nowhere.”

“Government should not content itself with councils’ ability simply to meet the legal minimum for care provision,” continued Hillier. “Nor should it seek solace in measures that risk opening a prolonged debate on the challenges facing the sector.”

Responding to the report, Cllr Linda Thomas, vice chair of the LGA’s community and wellbeing board, said: “This report lays bare the stark facts behind the adult social care crisis which is of increasing concern for the entire sector and cannot be ignored by the government.”

She explained that although councils have done all that they can to prioritise and protect adult social care, the combination of historic funding restrictions, rising demand and increasing cost pressures, means that many authorities are having to make significant savings and reductions across their budget.

“This is leading to an ever more fragile provider market, growing unmet and under-met need, further strain on informal carers, less investment in prevention, and continued pressure on an already-overstretched workforce," she added.

With the adult social care funding gap set to exceed £2bn by 2020, she warned: “Unless immediate action is taken to tackle increasingly overstretched council budgets, the adult social care tipping point, which we and others have long warned about, will be breached, which will lead to a substantial increase in people’s care needs not being met and overspending by councils.”

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