Social care crisis spinning out of control
Published by The I paper (22nd November, 2021)
We can see clearly the shape of Boris Johnson’s premiership after 28 months – and it is not the prettiest sight as it lurches from crisis to crisis. His approach relies on four pillars: blaming others, the defining creed of his Brexit cabal that pushed a puerile idea that complex global problems could be cured by populist gesture; boosterism, in which he promises so much and yet delivers so little; chaos, with the sense of permanent confusion and disorder that permeates Downing Street; and finally constant U-turns that are an inevitable result of such an approach to governing.
The social care farce highlights the first three pillars with frightening clarity, despite the gravity of the impact on millions of citizens in desperate need of support. This is, bear in mind, an issue about people with dementia, disabilities and chronic health conditions – and families struggling to survive at times of immense crisis. Yet Johnson first came to office promising he possessed a plan to “fix the crisis in social care once and for all”, which was simply a bare-faced lie. Then two months ago, he promised parliament he would “finally be dealing with social care” – while taking swipes at Labour for failing to tackle the problems despite his own party running the country for the past 11 years.
This was, sadly, another deceptive stunt. Johnson was not even offering a sticking plaster for the gaping wound in the underbelly of our society exposed again by the pandemic. There was a tax rise given populist branding as “the health and social care levy” – although it was just a hike in national insurance, taking another £12bn a year largely from those in work. Almost all the cash will be soaked up by the National Health Service, with its unquenchable thirst for funds – in theory until 2024, but most likely for eternity. The trickle that gets through to social care was designed only to deliver a cap on costs for those better-off families that sell their homes to fund care.
This mild reform – aimed firmly at the Conservative electoral base – offered little to a demoralised sector that has long been seen as the second-rate public service despite its crucial importance. It did nothing to tackle catastrophic staff shortages inflamed by Brexit and the pandemic, the appalling low pay of people working on the frontline, the exploitative fat-cat providers creaming off profits into tax havens. A few crumbs were chucked at local authorities, crippled by a decade of austerity amid surging demand for care, and at training, which does nothing to solve the current staff crisis confronting care homes and families.
Yet now even this limited reform has started to dissolve, demonstrating even more starkly the hollowness of Tory talk about levelling up. Johnson, the great snake-oil salesman, promised no one would need to sell their home to fund care. Yet it has emerged that his government is tweaking the means test system to ensure poorer older people will have to use up most of their assets when attempting to access support by saying state-funded costs will not go towards the £86,000 cap. “Those with lower levels of wealth may well wonder why the PM’s promise that no one need sell their house to pay for care doesn’t seem to apply to them, but only to much wealthier people,” said Sally Warren, director of policy at the King’s Fund think-tank.
Little wonder disgruntled Red Wall Tory MPs branded this move “an inheritance tax on the North” after they swallowed the tax rise and then saw their leader stumble so badly over sleaze. There are threats of fresh revolt in parliament, so there may be yet another U-turn over another self-inflicted problem. Meanwhile, there is bickering between the Treasury and health department over who is to blame, although many believe Sajid Javid – a minister whose shrimp-like political skills would leave him out of depth in a paddling pool – wanted to divert the £900m savings into other health concerns.
Once again the NHS seems sacrosanct, soaking up an ever greater proportion of state revenues, while the care sector and all those beleaguered families reliant on the state for life-enabling support get swept aside. Yet the staff crisis is so intense that managers are handing contracts back to local councils, services are being cut and pleas for help are being rebuffed.
The Care Quality Commission has warned of a looming “tsunami” that will leave people without care as “exhausted and depleted” staff quit for better-paid posts in pubs and supermarkets. Already I have heard of care teams so overwhelmed as vacancies go unfilled that they have slashed support to simply ensure clients are safe rather than carry on trying to help them enjoy decent lives.
This is the harsh reality of a shattered system while Johnson struts around talking about fixing social care. I have seen the urgency of the problems with my own family, trying to recruit staff for my daughter with profound needs in a city where almost one in eight care posts are unfilled. It is estimated our country will need almost half a million more carers to cope with increasing demand from a population that is both ageing and with more working-age adults with disabilities. Yet the only way to grab political attention seems to be the argument that care problems impact hospitals when elderly or sick people block beds.
It is testament to the collective failure of Westminster and our short-sighted, tribal political system that there is little focus on care, even after so many needless deaths in a pandemic. This is not just about money, but also about status and wider attitudes. Perhaps politicians are only responding to a society that seems to lack compassion or concern for its most vulnerable citizens. Yet have no doubt: the care crisis is spinning out of control while Johnson and his ministers play sick political games.