These increases were initially introduced to raise £36bn over three years, of which £30.6bn in that period would go to the NHS to cope with the Covid backlog, and £5.4bn to fund social care reform.
Subsequent criticism and pressure from Tory backbenchers forced a minor change, with the then chancellor raising the earnings threshold from £3,000 to £12,570, meaning the actual sums raised would be less than this.
Irrespective of what the actual sums would have been, in reality the £5.4bn ringfenced for social care reform were not designed to address the issue directly but to fund the infrastructure around the social care changes. Although it was intended that after three years all the extra funds raised would go to social care, this does presuppose that the NHS would no longer need it.
The government is, however, adamant that it will deliver the social care reforms promised in its original manifesto and set out in the aforementioned health and social care paper. But the question remains as to how this will be funded.
Insufficient funds
Also of concern, is the Local Government Association’s view that funds of £5.4bn over three years are insufficient to cover the costs of the introduction of the cap, a more generous means test and the ability for self-funders to ask their council to arrange their care costs. This is before even looking at improving the quality of care itself.
Of course, the issue of social care has been a problem for successive governments over the past 25 to 30 years or more.
No one is saying it is an easy problem to fix but it is all too easy to forget when looking at these problems – the number of individuals requesting or receiving care, the quantum of state or local authority spending and the inequalities between NHS and social care – that we are dealing with real people.
People who have made a contribution to society but who are now vulnerable and in need.
In his first speech as prime minister, Boris Johnson promised to “fix the crisis in social care once and for all, giving every older person the dignity and security they deserve”. Scrapping the NI increases therefore feels like a backwards step. With several pressing issues facing the UK economy at present, it would be easy to see the looming social care crisis slip down the agenda, and this is worrying.
Taking care of the future
Over the next 13 years, those aged 80 and above in the UK will increase from 3mn to 5mn – the biggest percentage increase since records began. Many, if not most, may not have access to publicly funded care and will need to make at least a partial contribution to their care, while many more will have to meet their costs in full, which may be extremely high.
Giving proper consideration to making appropriate provision for future care is therefore essential. Prior to the release of the government’s own paper on health and social care reform, St. James’s Place produced a social care report outlining a number of innovations and ideas that could help to create a better, more integrated system to tackling social care issues.
These include measures such as granting additional tax benefits on payments from existing pension arrangements to fund care, and utilising private care insurance, with contributions based upon a combination of age, health, family history and level of benefit purchased.
These could not only help spread the costs more widely across society and move some of the risk to the private sector, but also raise public awareness of the need to prepare for social care expenses.
Clearly, there is no immediate or perfect solution, but sadly the problem is not going away. We hope it is given serious thought soon.
Tony Mudd is divisional director for development and technical consultancy at St James’s Place