Today’s announcements on social care: a cap of £86k, a tapered ‘floor’ of £20-£100k and a 10% (1.25 percentage points) rise in National Insurance (NI) also known as the ‘Health and Social Care Levy’ have been disappointing to many of us waiting for a serious response to the social care crisis.
Reform has been needed for many years and has been made more urgent by the impact of the pandemic on the care sector.
The proposals are deeply disappointing: just 15% of the National Insurance rise (£5.4bn) will fund social care with the remaining £30.6bn going to the NHS. Whilst the NHS is in significant need, brought to its knees by austerity, an announcement on social care without adequate social care funding leaves many worse off, at risk, and without hope that quality of care will also improve with the upcoming ‘reforms’.
This is not social care charging. This is an NHS levy after years of insufficient funding and dangerous backlogs with an inadequate social care aspect.
Crucially, this does not come into play until October 2023 and it is unclear how the new cap interacts with those who are under the current system.
Social care is critical to independent living for many. What is on the horizon, a regressive tax on wages instead of wealth, is not the change we needed.
Of the £5.4bn for social care, £2.4bn covers the care cap which leaves £2.9bn over 3 years for reforms. The Department of Health and Social Care’s C19 Taskforce states “The restoration of mental health related adult social care budgets to 2010/11 levels is a priority; in 2018 this was estimated at an additional £1.1 billion per annum”. In 2019-20 alone, around £2bn was spent on local authority arranged care related to mental health. These figures dwarf the proposed offer. Before reforms have even begun, we can see that they will most likely be inadequate for those whose social care includes support with mental ill health/distress needs.
The income threshold for NI is £9500 whilst for income tax it is £12570. In addition to existing council tax rises (a 9.5% increase in Greater London for 21/22), an increase in NI ups the pressure on some of the poorest households who may already be facing the looming £20 a week cut to Universal Credit.
What are the alternatives? Taxing assets, wealth, and inheritance. Many will need social care at some point in their lives and many work in social care. For good quality care, we need to ensure care workers are treated fairly, with equitable contracts and a living wage. For unpaid carers, more is needed than the ambiguous offer of “support, advice and respite”.
If we are to take social care seriously, we must raise significant funding from wealth, and tax progressively so the poorest are not disproportionately out of pocket. A regressive tax on NI is not the answer to the social care crisis.