The Local Government Association (LGA) estimates that by 2020, the social care funding gap will be over £2.3 billion1. The publishing of the social care green paper – anticipated in July - will help to provide clarity on sustainable financial fundamentals to address future demand on services.
Why the green paper is needed
Austerity has forced commissioners into a tense relationship with the market, divesting capability and curtailing investment. Since 2010, austerity has hit adult social care hard. For example, in 2017 the Association of Directors of Adult Social Services (ADASS) estimated £6 billion had been cut from councils’ adult social care budgets since 2010 - at a time when the need for services is growing2. The sector faces further deterioration as quality in the market drifts away from inadequately provided local authority services to self-funded beds and care. The inequality manifested in this trend must be checked.
And the policy position is scarcely better. Adult social care, to quote David Behan, ‘cannot afford to be seen through the prism of the NHS’ but that is precisely how these distinct and critical needs have been viewed. Better integration is needed across the NHS, local authorities and other social care providers.
So what do we need from the green paper?
The green paper serves a great, perhaps even historic purpose. Just as the slew of green and white papers achieved in the noughties on social care, 2018 is now the time for change. But this time in the financial fundamentals. Funding for future demand is the big question for government so the green paper, followed by an austerity-busting budget, is the answer. But look at the detail and we can see it will be no mean feat to inject cash in a way that is prudent, fair, effective and sustainable. Borrowing to raise cash is not the answer – social care needs a sustainable solution that can only be achieved by aligning tax and spend. And around the big financial questions are some smaller but equally important ones – for example how councils can be encouraged to invest and intervene in local markets.
It will be tempting for government to say and do more on issues as varied as technology, regulation and integration. But without any new legislation in the foreseeable future, the adult social care system, led by town halls, providers and professionals should be given the chance to do the job they want to. Government policy should seek to address key problems, not hamper the delivery chain.
To discuss the social care green paper, please contact Alex Khaldi.