England’s largest councils have backed government plans to introduce a cap on care – but warn that it must be fully-funded otherwise it will inadvertently push services, care providers and councils closer to breaking point.
The recommendation for a fully-costed cap comes in a new report, ‘Sustainable Social Care: A Green Paper that Delivers a New Deal for Counties’, which sets out the County Councils Network’s policy positions on adult social care, ahead of the forthcoming government green paper.
The paper argues that if the government’s reform agenda is to be successful, then social care must remain a local service and ministers should ‘not be swayed’ by overly-simplistic arguments to combine all, or elements of social care into the NHS.
With counties facing a funding gap of £1.6bn in social care by 2020/21 and new figures showing the average county authority now spends 45% of its entire budget on adult social care, the report makes several key recommendations to government;
- If government implements a cap on care at £50,000 per individual, this could cost county authorities collectively £691m a year – double that of a £72,000 cap which was previously put forward.
- County leaders suggest these reforms, and the funding gap, could be filled by national taxation and means-testing of winter fuel allowance and attendance allowance to avoid ‘catastrophic consequences’ for local services. Separately, they say they agree with the exploration of further proposals to make the system sustainable, including the recently floated ‘social care levy’ proposals.
- Social care must remain a local service, and social care councils’ role in the reform and integration agenda should not be overlooked by government. Councils contain democratic accountability and strong links to other service areas, such as housing, and they have a proven track record in financial prudence and commissioning.
- With the number of over 85s households in county areas set to rise to ‘unprecedented’ levels by 155% over the next two decades, government must address shortages in both retirement properties and supported housing, by introducing reforms to the planning system and to the administration of grant funding such as Disabled Facilities Grant.
- Prevention should be a key focus of the green paper. To that end, government should invest a ‘significant’ proportion of the £20bn NHS windfall in primary, community, and mental health services.
The government had been poised to introduce a £72,000 cap in 2014 before it was postponed. The 2017 Conservative Manifesto dropped its commitment to the cap, but they have since restated their commitment to the policy and it is expected to form part of forthcoming proposals.
Cllr David Williams, County Councils Network spokesman for health and social care, and leader of Hertfordshire County Council, said;
“County areas are withstanding some of the greatest financial and demand-led pressures in delivering and procuring social care services, and have had some of the biggest cuts in core government grants since 2010. These pressures will only continue to intensify in the coming years, with counties home to the largest and fastest-growing elderly populations, and they already spend close to half their budgets on social care services.”
“Faced with these current pressures, and an elderly population that is projected to increase to unprecedented levels in rural areas, financial reform for the system and protection for individuals from huge costs are necessary. That is why we are backing a cap on care cost contributions – but this must be fully-costed for local authorities, otherwise it will have catastrophic consequences as it push under-pressure social care services to the brink of collapse.”
“This report today sets out policy proposals for government ahead of the social-care green paper. The status quo is no longer an option; ministers must be bold in ensuring sustainable financial reform. With care services and the NHS interdependent investing in one but not the other is financially irresponsible.”
“Above all, social care must continue to stay a local service and ministers should not be swayed by overly-simplistic arguments to combine all, or elements of social care within the NHS. The challenges local government has faced in delivering balanced budgets whilst ensuring that those most in need receive high-quality care must not be underestimated – without the leadership and innovation shown at a local level, the present situation could have been a lot worse.”