What is the Government proposing?
Last week, the Government announced a new independent commission to reform adult social care. The commission will deliver an interim report in 2026, which will ‘identify the critical issues facing adult social care’ and set out medium term recommendations for reform, before recommending longer term changes in 2028.
In the same press release, Health Secretary Wes Streeting also announced an extra £86 million this financial year for the Disabled Facilities Grant, which helps elderly and Disabled people to make adaptations to their homes, and committed to increasing the use of technology to make social care more effective.
Our concerns
NSUN echoes concerns expressed by key figures in social care about the commission’s proposed timeline: those relying on a broken care system now cannot afford to wait three years for a list of recommendations.
As highlighted by the Greater Manchester Coalition of Disabled People, it is likely that this commission is just a means for the Government to avoid committing to the inevitable financial cost of a functioning care system for as long as possible.
Serious and persistent problems in the social care system are well documented. These include dangerously inconsistent care quality, exorbitant costs and extremely limited government assistance, which has led to people having to sell their homes in order to be able to finance their care. We do not need an independent commission to identify this, or to work out that we need a care system with secure financial backing from the Government.
Elsewhere, while details on how technology will feature in social care reform are scarce, the Government must make sure that care services do not exclude those who are unable to be online or are not digitally literate. We are wary of data-sharing between the social care system and other institutions because of the risks this practice can pose to people with precarious immigration statuses.
What should we be looking out for?
While we remain deeply sceptical about the Government’s willingness to genuinely reform the care system, keeping a close eye on the following issues will indicate how serious the commission is.
Meaningful co-production
To have a chance at creating the change we need, the commission will need to actively engage with people who have lived experience of the care system. Elderly people, Disabled people and their organisations must be invited to make decisions about how it consults with people and what questions it asks.
The focus must be on supporting the right of social care users to choose how they live their lives. Given that the commission is expected to begin in April this year, there is still time for meaningful co-production to be built into its work.
Willingness to tackle private sector involvement in social care
Outsourcing in adult social care since the 1980s has led to a poorly-regulated, profit-driven sector in which care quality has declined and private providers prioritise wealthy, self-funded care users. This is one of the key reasons for the state of the social care system today.
NSUN has written on the failures of private companies running inpatient mental health care facilities, immigration removal centres (IRCs) and prisons. In many cases, these same companies provide adult social care. Any commission that neglects to question the role of the private sector in adult social care provision will be unable to bring about a genuine alternative to the current system.
A National Care Service for all
It is assumed that the long term result of this commission will be the creation of a ‘national care service’, about which we currently know very little. Whatever form this service takes, the Government must ensure that it can offer support to all who need it, and that it prioritises autonomy, dignity, and the right to independent living in its approach.
Adult social care must have enough government funding behind it to ensure that people are not forced into extreme poverty by care costs. Alongside proper funding for the sector, recent research also invites us to consider bringing social care back under public control in order to ensure high quality, accessible care for all. In the short term, concrete steps towards this could include capping profits and limiting shareholder dividends.
If the Government really wants to ‘meet the current and future needs of the population’, as the press release alleges, establishing a social care system that is fit for purpose should be the bare minimum. Elderly and Disabled people’s organisations must be properly funded and valued for their lived experience perspectives, without which no Government can hope to create a society in which we can all participate.