Social care reform encountering fork in the road

New analysis of funding pressures on social care by the Health Foundation and The King’s Fund have emphasised the worrying lack of progress on social care reform in the UK.

The two health bodies say that a lack of agreement on what should be done and low public awareness are the main barriers to progress. Noting that reforming the current system will be expensive, the analysis claims that progress is now at a clear ‘fork in the road’ with a choice between a better means-tested system and one that is more like the NHS; free at the point of use for those who need it.

The report finds that the current system will lead to a funding gap of £6 billion by 2030/31, and that returning to levels of access and quality last seen in 2010 would increase the gap to £15 billion. However, by introducing more fundamental reforms we would also see an increase in costs, with free personal care for all older people with needs above the current threshold incurring an extra £14 billion, and protecting people from having to sell their homes by implementing a cap on the lifetime costs of care would require £12 billion.

Ipsos Mori recently reported that most people would prefer a dedicated tax to stop the money being diverted elsewhere, with options such as people selling their homes to cover care costs, as exists now, found to be deeply unpopular.

Anita Charlesworth, director of Research and Economics at the Health Foundation, said: “We have reached a fork in the road and reforming social care is now urgent. Despite the obvious challenges, the government’s green paper must build wide consensus on which direction reform should take, and lead to real progress and improvement. More and more vulnerable people will suffer if bold action is not taken to sustain this vital public service.”

Simon Bottery, senior fellow at The King’s Fund, said: “The case for change is overwhelming - patching up the current system would be costly and would not tackle its fundamental flaws. As the government prepares its forthcoming green paper, at least two alternatives should be on the table – a better means-tested system and one offering free personal care, which would cost similar amounts to implement. However, there is no silver bullet - the road to reform will be difficult and costly, whichever option is chosen.”

Izzi Seccombe, chairman of the Local Government Association’s Community Wellbeing Board, said: “This report shows that we need big, brave and bold decision-making if we are to tackle the crisis in adult social care, which needs cross-party consensus if we are to succeed. The case has been well and truly made that the system is in desperate need of both an immediate injection of money and long-term sustainable funding that secures care and support for older and disabled people now and in future generations. The government must seize the chance to address these challenges in its Green Paper and deliver reforms to future-proof adult social care.”