Why is social care and disability missing from the debate on a no deal Brexit?
A no deal Brexit on the horizon and concerns are rife about the potential impact on a number of key areas. There are widespread fears about shortages of medicine and risk to patients as well as worries about government cuts and extended austerity.
Yet there is not the same national focus on the impact on disabled people and on the social care sector that supports them if the UK leaves the EU without an agreement.
VODG is a group that brings together voluntary organisations that support disabled people. Since the EU referendum, VODG has carried out a dedicated programme of work supporting organisations through the uncertainties and challenges of Brexit. Our stock takes of how the issue will affect our members places us in a unique position to identify the challenges facing social care as a result of a no-deal departure.
Leaving the EU without a deal could lead to an economic downturn that will result in significant concerns for support providers. The already fragile publicly funded social care sector is in desperate need of more funding to meet rising costs and demand; any further decimation of public finances would lead some care organisations to collapse entirely.
As VODG has already warned in its Brexit risk register and mitigation plan, rising inflation is a key risk alongside the growing costs of care. A weakened economy could also exacerbate demand for social care, something that providers and the voluntary sector could struggle to meet.
Alongside the economic impact of a no-deal scenario, there are more than 300 EU directives that relate solely to disabled people and specifically to their access to jobs and training. What shape will these rights be in after an abrupt departure from the EU? In addition, while the headlines warn about Brexit draining the UK of NHS staff, we need more debate about and solutions to the loss of individuals from the social care workforce (some 90,000 people from EU countries work in adult social care, for example).
The government has sought to soothe concerns with its recent report, What if there’s no Brexit deal?, but the publication offers little in the way of detailed reassurances, especially for social care. Similarly, although the Department of Health and Social Care has published a number of technical notices and guidance documents about planning for a potential no-deal, including those aimed at the health and care sector, these provide factual explanations rather than any sense of strategy or joined up approach. The associated letter from health and social care secretary Matt Hancock is equally thin on detail, failing to set out much practical guidance for organisations.
One of the key issues that VODG members identified following the referendum was the risk of government being distracted from vital domestic policy areas. It is right that the policy attention is indeed on disentangling the UK from Europe, but the consequence seems to be a lack of focus on existing issues in our own backyard, such as the fragile state of our public sector finances.
For example, the long awaited social care green paper was initially promised in July, then delayed again with promises that it will appear after summer recess. Now, according to recent comments from minister for care Caroline Dinenage, it seems as if it is being put off yet more. As we warned in research dating back to 2016 “there is a very real risk that domestic policy becomes the poor relation to Brexit losing both focus and momentum”. That risk is now being realised with, for example, social care funding and workforce issues being overlooked in favour of the Brexit agenda.
According to a recent letter signed by NHS Providers chief executive Chris Hopson, there has been “radio silence” from NHS England and NHS Improvement in the face of a no deal Brexit and there is a need for “active national leadership”. Social care faces absolutely the same radio silence and government must reach out and work with the sector.
Many of the risks we have been highlighting since the 2016 referendum remain unaddressed. Social care already faced a financially unsustainable future before the additional uncertainties of Brexit. Now Brexit further threatens to undermine services for disabled people. With the very real prospect of the UK leaving the EU without a guaranteed agreement, clarity from government is needed more than ever if the care sector is to continue delivering the vital support that so many people rely on.