6 reasons to care about the crisis in care
Adult social care is in crisis and we need to start caring about it right away. Here are six reasons why.
1. Someone you know will need it — and soon
Adult social care is the care we give to those who need it most: people who have serious difficulties looking after themselves because of illness, disability, or life condition. Around two in three of the roughly 850,000 people who get it from their local council are elderly; the other third are adults with physical or learning disabilities or serious mental health issues.
We’ll need a lot more of it in future. By next year, we’ll have three million people living with three or more long-term conditions, like chronic illness or disability. In 2019, there will be nearly six million people over the age of 75. And in less than a decade, we’ll have a million people with dementia.
People are living longer — that’s great news. But they’re also living with conditions that they previously wouldn’t have survived with. That means we’re going to need more care, not less.
2. Those who need it aren’t getting it
Things are going the wrong way. In 2009, councils were caring for over a million people. Now it’s a quarter fewer. That’s despite rising demand and a massive new law, called the Care Act, that made it a legal duty for local authorities to look after people with the most serious need.
Councils have been looking after people for a lot longer than the government has been telling them to. When it was left to town halls to decide, they kept thresholds relatively low so more people could get help.
But after six years of pain inflicted on council finances, those thresholds have risen to the legal minimum. Only those in a critical condition get looked after. Everyone else has to rely on friends and family or private care they fund themselves, sometimes by selling off the family home. AgeUK think over a million people who need help with basic daily activities aren’t getting it.
Of course, most care will always be provided by nearest and dearest. But with over 6.5 million people acting as unpaid carers, a rise of more than 600,000 in a decade, the pressure on some families is becoming intense. And if that system of informal care crumbles, the alternative is totally unaffordable — it would take the entire budget of the NHS to pay for the time that friends and family put in to caring for their loved ones.
3. It’s hurting the NHS
If you’re not yet convinced that social care matters to you personally, consider the knock-on impact for the NHS. When social care isn’t available, two things happen: some people get stuck in hospital when they should be cared for in their own homes; and other people end up in hospital because they weren’t cared for properly at home.
Last year, 650,000 hospital bed days could have been avoided if social care had been properly funded. That’s why the head of the NHS, Simon Stevens, said: “I think… that, were extra funding to be available, frankly we should be arguing that it should be going to social care [rather than the NHS].”
And Stephen Dorrell, a former Conservative health secretary, described cutbacks on social care as “insane economics”:
“If you cut back on all of those things, what you’re doing is using the NHS as a kind of extended community care system.”
Your GP surgery and your A&E department are busy because people who should be getting social care are seeing their doctor instead.
4. It’s bankrupting councils
No one cares much for council finances until it means their bin isn’t cleared or their library is closed (see How to set a council budget in a financial storm). But the reality is that adult social care is one of the biggest cost pressures on council coffers.
After the first five years of austerity, councils were funding rising social care costs by diverting £2.5 billion a year from other budgets. Given that the entire national spend on Children’s Centres is just £750m, that’s a major chunk of local services that have had to be cut to keep social care going.
It gets worse. By the end of the decade, the social care funding gap will widen by another £2.9 billion. With councils facing another 60% cut in their central government grant, the maths really doesn’t add up.
5. It’s a major cause of low pay
The blight of low pay and insecure working is one of the biggest problems in post-Brexit Britain. Resolution Foundation found that over six million people earned less than the Living Wage in 2016. 850,000 of those worked in health and social care. That means the state is directly responsible for at least one in seven workers earning poverty pay.
It’s not only pay. Over 100,000 care workers are on zero hours contracts with no guarantee of the work they’ll get from week to week.
Poor pay and conditions leads to high staff turnover, a workforce without training and experience, and low morale. The quality of care suffers. And our economy ends up with hundreds of thousands of low paid workers.
6. It’s the test of a decent society
Put all that to one side. A basic tenet of our society is that we help those who cannot help themselves. That’s what social care is all about.
It’s about me, you, our parents and our grandparents who, for a hundred different reasons, may find ourselves one day unable to perform the most basic functions of life. That’s when we call on the care system. That’s when we need it to be there for us.
Ghandi said, “a nation’s greatness is measured by how it treats its weakest members.” Today’s social care crisis is a test for our nation. We must not fail it.
Adam is a councillor in Harrow and the cabinet member for Finance and Commercialisation. He tweets @adamswersky
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