Home care ‘left out in the cold’ in government plans for reform, say sector leaders


Home care has come out as the “poor relation” to the NHS and the wider social care sector under government proposals to reform the system.

That’s the view of care leaders who say that despite the rhetoric, we are “no closer” to fixing the generational crisis that is “engulfing” the sector.

The Prime Minister told MPs yesterday that increasing national insurance contributions by 1.25% will raise £36 billion for health and social care over the next three years.

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Of this, £30.6 billion will go to the NHS to help tackle waiting lists. This means that only £5.4 billion will be available for social care and just a proportion will be used to fund home care.

Just under half of the £5.4bn (£2.5bn) will be used to pay for the “Dilnot proposals” to implement a cap of £86,000 on care costs.

But with only one in seven spending more than £100,000 on care costs, this is not likely to help many, according to United Kingdom Homecare Association chief executive Dr Jane Townson.

Commenting on yesterday’s reform proposals, Dr Townson said: “Once again, the government’s focus is on the 0.5 million people in institutional care, rather than the 15 million needing support and care at home.”

Boris Johnson announced in Parliament that, from October 2023, anyone with assets of less than £20,000 will not have to make any contribution from their savings or housing assets, up from £14,000 today.

Meanwhile anyone with assets of between £20,000 and £100,000 will be eligible for some means testing support

This means that, in theory, more people will be able to receive state funding for care.

However, Dr Townson explained in a blog post that with only £5.4bn being made available for social care for three years, eligibility criteria for state-funded care are likely to remain high.

“It makes no sense to neglect older and disabled people in the community, wait until a crisis point is reached, then transport them to acute hospitals, where they frequently lose function, deteriorate rapidly, and require even more long-term care. But this, it appears, continues to be the government’s strategy,” she said.

Right at Home CEO Ken Deary said of the reform proposals: “Whilst the 1.25% levy earmarked for health and social care, together with introducing some of the Dilnot proposals, looks a very positive move forward, the detail tells us that only £5.4 billion will be allocated to social care over three years, of which only a proportion will be allocated to home care.

“Again, home care has come out of this as the poor relation in terms of overall funding, which will mean that councils may not be able to adequately fund home care. The knock on effect being our vulnerable clients, providers and, of course, our fantastic staff will not benefit from ‘the fix to social care’ that the PM promised.”

Mark Adams, CEO of Community Integrated Care, one of the UK’s biggest social care charities, said the while reducing the cost of care for older people is vital, the government has failed to recognise family carers, disabled people and social care workers.

“This solution doesn’t ‘fix social care’ but instead tidies the tip of the iceberg,” he said

“Every citizen has a stake in supporting a thriving and sustainable social care sector, but through choosing National Insurance as the method to raise investment, the debate around social care funding has become divisive and misunderstood.  Ironically, the focus on NI will likely compound the problems faced by both social care providers and their colleagues, who desperately deserve fairer pay, as we both now face increased National Insurance costs.”

Adams continued: “The government cannot represent to the public that this presents a fix. It needs to urgently work with the sector and people who access social care to truly build back better. This means fair pay, fair access, fair funding, and a genuine focus on driving innovation and quality, to ensure that every person can lead a good life.”

Martin Jones, CEO of Home Instead UK and trustee at Age UK, said while yesterday’s announcement is welcome, funding is only part of the national solution, adding that it’s time home care was “brought out of the cold”.

“The majority of social care is currently provided by carers in the homes of the individuals being cared for, helping to provide tailored support, choice and ensuring the highest quality of life.  Yet home care has historically received relatively little attention from policy makers, when compared to care homes. Now is the time to bring us in from the cold, and ensure quality home care is central to the new integrated national care solution helping to relieve pressure on the NHS,” he said.

“To deliver truly historic and impactful reform will require a deeper look at how the whole health and social care system operates and this must always start and end with what is needed to ensure the quality of care being delivered is what we would all expect for our own loved ones.”

Dr Ben Maruthappu, CEO and founder of Cera, commented: “Sadly, social care continues to be treated as the poorer sibling to the NHS, and we need to see greater levels of parity between the two. Additional funding is a big step in the right direction and is very much welcome, however it will take much more than just money to address the most pressing issues facing social care in the UK. For the two services to integrate more and work together productively, we need to see much greater equality in terms of investment and resources.

“Whilst reducing the financial burden on those who require care is important, it doesn’t address the core infrastructural challenge facing social care, which is a lack of capacity. There must also be a concerted effort to attract new talent into social care, to solve resourcing issues and help put people back to work after the pandemic in new and rewarding careers.”

UNISON general secretary Christina McAnea said the £5.4bn allocated to social care is “nowhere near” what is needed to fix the system

“Social care needs more than just a tweak, it requires wholesale change from top to bottom,” she said.

“Those currently in receipt of care and the thousands more who need support but can’t get it for love nor money will feel extremely let down today.

“Fund the sector properly, deliver for low-paid staff and take the profit out of caring. That is what’s needed, but the government has fallen far of that short today.”

Tags : national insurancesocial care reform
Sarah Clarke

The author Sarah Clarke