Social care has been a difficult topic for successive Governments to tackle. With an ageing population and a potential elderly care crisis, the issue of social care has become more prominent. However, the Government’s interest in the topic has fluctuated and the policy area has often been overshadowed by controversy. Despite these difficulties, it is acknowledged on both sides of the House that social care will be an area of increasing importance in the future, as reflected in the Coalition’s pledges.
The proposals made by the Dilnot Commission in 2011 set the scene for the key debates in social care. The Commission’s proposals included a cap of £35,000 on care costs, as well as free social care for people with long term conditions. Yet, as with so many of the Government’s plans, economic reality quickly set in. The Dilnot Commission predicted that its proposals would cost the state around £1.7 billion, a number that the Treasury saw as an underestimation, and the prospect of a grand bargain between parties quickly receded. Yet in early 2013, months after the proposals had last been discussed, the Government announced plans for a cap on care costs of its own. The proposed cap will be set at a higher rate than Dilnot called for and will not fully implement the Commission’s recommendations. However, these proposals may be the first step in a gradual movement towards a fully integrated health and social care system.
Disability issues have also been highly controversial for the Coalition. The Government was criticised for the closure of Remploy’s factories, despite many of the closures having been implemented by the previous Labour government. Changes to Disability Living Allowance, and the use of ATOS to assess eligibility for disability benefits, also attracted the ire of campaign groups and the Opposition. All of these developments have added to a perception that Government cuts are having an unfair impact on the disabled. Despite this, the Government has pushed ahead with a number of positive developments, such as the extension of personal budgets and additional funding for carers.
The Draft Care and Support Bill presents a major chance for the Government to push ahead with further reform to the social care system. The level of reform the Bill will achieve remains to be seen; however, the inclusion of housing alongside traditional forms of care suggests that the Government is thinking innovatively about solutions to the care crisis. Providing the care system isn’t hit with another Castlebeck-sized scandal, the Coalition may be able to make further progress in this area before 2015. However, a long term solution to the future funding of care appears to be some way off.
Progress against the Coalition Agreement
Pledge: We will establish a commission on long-term care, to report within a year. The commission will consider a range of ideas, including both a voluntary insurance scheme to protect the assets of those who go into residential care, and a partnership scheme as proposed by Derek Wanless
Status: Done - The Dilnot Commission was established after the General Election and reported in July 2011. While the report was seen as a positive development, its implementation is still a matter of debate.
Pledge: We will break down barriers between health and social care funding to incentivise preventative action.
Status: In progress - Small steps have been made towards an integrated health and social care system. Some elements of the new NHS commissioning system will focus on integration, as does the Draft Care and Support Bill. However, it currently remains difficult to quantify to what extent these changes will incentivise preventative action.
Pledge: We will extend the greater roll-out of personal budgets to give people and their carers more control and purchasing power.
Status: In progress – The Draft Care and Support Bill aims to create a statutory underpinning for personal budgets. Norman Lamb, Care Minister, announced in November 2012 that 56,000 people in England with significant health needs would be offered personal health budgets.
Pledge: We will use direct payments to carers and better community-based provision to improve access to respite care.
Status: In progress - The Government has published a Carers Strategy, including a £400 million fund to offer respite care. However, the strategy is to be implemented over four years and its overall success cannot yet be determined.
Pledge: We will reform Access to Work, so disabled people can apply for jobs with funding already secured for any adaptations and equipment they will need.
Status: Done - The Government has increased Access to Work funding by £15 million. However, the closure of Remploy’s factories and the DWP’s outsourcing to ATOS to judge disability benefits, have been criticised by campaigners as a retrograde step in providing employment to the disabled.