The pandemic has thrown up many problems, chief amongst them the state of the care system in England in particular. We are all familiar with the discharging of elderly patients suffering from COVID to care homes in the first half of last year. Indeed, there was a tragic example at one of our local care homes in Bicester.
But the pandemic has thrown a light on the care system as a whole, not least locally where care at home has been under immense pressure. 15 minute calls are common and there are examples cited by local carers themselves of increasingly poor quality of care. This is partly down to lack of staff (over 100,000 vacancies nationally), but also to the inability of staff to complete sometimes quite basic provision – getting someone with mobility problems out of bed, showered, dressed, preparing breakfast, and cleaning up afterwards – within 45 minutes!
Carers themselves are not always paid from the time they start work to the time they finish but only for the length of the calls they make and 40p per mile between jobs. In some cases, the effective pay for a full days work including travel barely amounts to £4 per hour, well under minimum wage which itself is hardly enough!
There is no doubt that social care – whether residential or at home – is in crisis. Local authorities responsible for social care have seen the funding cut by almost 40% in real terms over the last 10 years. At the same time, local council statutory duties, of which social care is just one, have not diminished. Faced with reduced budgets, local authorities have paid lower amounts to social care providers, which in turn has fuelled the crisis.
In 2019/20, total expenditure on adult social care by local authorities was £23.3 billion, up more than £1 billion from the previous year. However, in real terms (adjusting for inflation), total expenditure was only £99 million more than the level it was in 2010/11, despite increasing demand for services. Adult Social Care spending in Oxfordshire was £221m in 2009 and only £197M by 2021, a cash and real terms cut in practice.
Social care is often mistakenly believed to be, solely spent on the elderly but just under half of the £23.3bn goes to working-age adults. For older people, the majority of spending (65%) is for those who need physical support, while for working age adults the majority (70%) is for those with learning disabilities.
Little wonder then that social care is in turmoil and now this week we have the Health and Social Care Levy which, Government would have us believe, will solve the problem. Rather than funding social care through more progressive tax measures, the Government has chosen to hike National Insurance rates for working people. This is characterised as making the young pay for care for the elderly but the problem is much more fundamental.
Workers will pay an extra 1.25% in National Insurance and, for the first time, over 1M retirees topping-up their meagre pensions through employment will have to pay the 1.25% levy. The measures are expected to raise £12bn a year or £36bn over the next three years of which only £5.4bn will go to social care and the remainder to the NHS. The new levy is regressive, putting the burden on poor and middle-income people rather than the rich and corporations and, more importantly, fails to address the ongoing local and national crisis in social care.