The introduction of the cap on care costs, part of a reform of adult social care promised by both Liz Truss and Boris Johnson, is to be delayed until October 2024, according to a report in The Times, as part of measures by the chancellor Jeremy Hunt to reduce spending.
According to The Times report, Hunt told his MPs on Monday that decisions on social care “will be taken through the prism of what matters most to the people who need help the most” and refused to guarantee existing policies.
The report adds that Hunt is said to want a year delay until October 2024. However, back in 2015 when Health Secretary he killed off a similar policy.
The care cap reforms, announced back in 2021 by Boris Johnson, would limit the lifetime sum people have to pay at £86,000 and introduce a more generous means test so those with assets of less than £100,000 receive help sooner. The reforms mean considerably more means-testing would have to take place which would require more staff.
The delay has been welcomed by Council leaders, however they warned that the funding allocated to the reform should be retained by authorities to plough into adult services. The funding allocated to implementation of the reforms by the Department of Health and Social Care (DHSC) was £771m in 2023-24.
In August 2022, The Local Government Association called for a six-month delay, then in October 2022 the County Councils Network (CCN) urged a 12-month delay to implementation. Council leaders are concerned about lack of adequate funding for the reforms and significant recruitment issues, in particular of social workers. They consider that the implementation in October 2023, as planned, would damage services at a time of already significant pressures.
Cllr Martin Tett, Adult Social Care Spokesperson for the CCN told Community Care:
“With local authorities facing severe workforce and inflation-fuelled financial pressures, they [the reforms] would be impossible to implement in the timescales without making services worse and leading to longer waits for a care package for people on day one of their introduction.”
“But while the implementation of the reforms should be delayed, the funding committed next year must be retained by councils and reprioritised, not used as a saving as part of the government medium-term fiscal plan.”
On the other hand, Sally Warren, director of policy at the King’s Fund think tank, told The Times that:
“Previous plans to reform social care were dropped in 2015, when Jeremy Hunt was health secretary, when reform was delayed and then never happened. For the sake of all of us and our families who may need social care, he must not back away again from vital reform now, and should press ahead without delay.”
Other commentators noted that the delay could signal that the care cap was being binned. King’s Fund senior fellow, social care, Simon Bottery warned on Twitter that delaying the reforms could mean their eventual abandonment:
“Delay may not sound too bad but is in reality just a step away from abandonment. A saving grace may yet be that a) cap costs don’t really kick in for a few years and b) surely the govt wants SOME achievements to point to at the next election?”
Hunt is due to unveil the plan on 31 October, when any decision about the charging reforms are likely to be announced.
It is unclear what any delay would mean for the six authorities – Blackpool, Cheshire East, Newham, North Yorkshire, Oxfordshire and Wolverhampton – due to implement the reforms in April 2023, six months earlier than the rest of the country.
This would not be the first time that a delay to reforms of social care preludes a decision to scrap them. Reforms had been due to come into force in 2016, before being delayed until 2020. Theresa May’s government then scrapped them altogether in 2017.
Reform to social care is vital, the system is in crisis. A recent report from Skills for Care shows that the number of vacant posts in adult social care have increased by 52% in one year – the highest rate on record – with 165,000 vacant posts. But the latest government white paper in December 2021 contained nothing to address this issue. Even if the care cap is addressed, who will then provide the care?
NHS Digital data released 20 October shows that compared to 2020/21, requests for support from both working age adults and older people went up, with local authorities receiving on average 5,420 requests for support every day of 2021/22 (up 170 requests per day on last year). Simon Bottery of the King’s Fund noted on Twitter that the data “suggests we may be returning to the depressing trend of more people asking for help but fewer people getting it.”
Labour plans national care service
In contrast to the current government, the Labour Party has taken a more holistic and radical approach to reform of social care and is committed to the setting up of a National Care Service. Back in July 2022, Shadow Health & Social Care Secretary Wes Streeting said that he had asked the Fabian Society to look at how such a service would be funded and structured. The immediate priority, noted Streeting being providing better pay, training and full rights at work for carers, and stronger national standards.
A national care service is not a new concept, appearing in the 2010 Labour manifesto and again in 2017. In July 2022 the idea was explored by Unison in its report Care after Covid. It makes the case that the Covid-19 pandemic has cruelly exposed the vulnerabilities in our care system that grew from a decade of austerity and from privatisations that started in the 1980s.
Unison’s strategy seeks to bring care sector staff and facilities back inhouse, eventually “fully integrating” with the NHS and delivering the vast majority of social care through public funding; but the union acknowledges the current reality that 97% of care is delivered by private or voluntary organisations, which means the transition to national care service will take time.
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