The Health Foundation and The King’s Fund have published today a working paper setting out interim findings from their project looking at the future funding options for Social Care in England.
Social care is facing a number of challenges; a widening funding gap, no long term national workforce strategy and increased demand for care due to an ageing population and an increase in complex care needs. Due to these challenges, it is now widely accepted that the system for funding social care is in urgent need of reform. The government has promised a Green Paper on Social Care with proposals to change the way care services work will be published by the summer.
Although social care reform is needed, the big question is how?
The working paper has looked at the funding of social care for older people in England from two broad perspectives.
Firstly, by looking at the attributes by which we should assess any funding system and by considering three key issues that are often confused in the ongoing discussion around social care, namely the following.
• What is the offer to the public and users that this money pays for? (or, what is the government responsible for)
• Where does the money come from?
• Who spends this money and how?
Secondly, by considering five current models of funding social care, models chosen either because they exist already in the UK (what we term ‘improving the current system’ and the Scottish model of providing free personal care), alongside hypothecation for social care, a single budget for health and social care, and the proposals put forward by the Conservative Party in the 2017 general election.
The paper does not make a recommendation, but sets out the implications of each of the funding options. It is the first output of a wider project looking at social care funding, which is due to publish its final reports in May.
The conclusions of the paper include:
- There is scope for making small improvements within the current system, and this approach would recognise the great difficulty successive governments have faced in achieving major reform. However, it would not address many of the fundamental problems with the current system, including the downward trend in the numbers receiving publicly funded care. Nor would it protect people against ‘catastrophic’ care costs.
- The Conservative Party’s proposals would have, for some, resulted in a more generous system than the one currently in place. However, there are real concerns around implementing and operating such a complex system. There is also a question as to whether this would be the best use of additional funding for social care.
- Whilst a joint health and social care budget might support progress towards more integrated care, it will not in itself address the differences in eligibility between the two systems, or generate additional revenue for health or care.
- Free personal care would mean increasing the government’s ‘offer’ on social care. However, given this would require an increase in public spending, there is a question as to whether this would be the best use of additional funding for social care.
- A hypothecated tax may help gain public support for raising additional funding for social care. However, this would represent a significant shift from the existing system, and could exacerbate the lack of alignment between the health and social care.
The project’s final three reports, expected in May, will also include research into public attitudes to social care, and demand modelling for the future.
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