The government should spend £8bn immediately to restore adult social care in England and then introduce free personal care funded through general taxation, a House of Lords committee has concluded.
A white paper with ‘clear and plausible proposals’ should also be published after decades of reviews and failed reforms. The Economic Affairs Committee said action was needed now, not a green paper.
Its Social care funding: time to end a national scandal report said: ‘With each delay the level of unmet need in the system increases, the pressure on unpaid carers grows stronger, the supply of care providers diminishes and the strain on the care workforce continues. government action, rather than further consultation, is required.’
Following the immediate investment, the government should introduce free personal care, such as help with washing, dressing or cooking, over the next five years, with it being available throughout the country by 2025/26, the peers recommended.
While the number of older people and working-age adults requiring care has increased funding has not kept pace but declined in real terms by 13% between 2009/10 and 2015/16, the report said. Funding is £700m lower than 2010/11 in real terms.
In 2016/17 local authorities spent £18.15bn on adult social care, divided between care for older people and for those of working age.
The report said any solution should put more money into the system through a combination of public and personal funding; better protect individuals from catastrophic costs; allow local authorities to pay care providers a rate that covers the costs of care; distribute money more fairly across local authorities; and invest in social care employees and ensure a more joined-up approach to workforce planning with the NHS.
The document said employees above the state pension age should no longer be exempt from national insurance and predicts this could raise more than £1bn.
Lord Forsyth of Drumlean, committee chairman, said: ‘Social care is severely underfunded. More than a million adults who need social care aren’t receiving it, family and friends are being put under greater pressure to provide unpaid care, and the care workforce continues to be underpaid and undervalued.
‘The whole system is riddled with unfairness. Someone with dementia can pay hundreds of thousands of pounds for their care, while someone with cancer receives it for free. Local authorities are increasingly expected to fund social care themselves, despite differences in local care demands and budgets.
‘The reduction in social care funding has been greatest in the most deprived areas. And local authorities can’t afford to pay care providers a fair price, forcing providers to choose whether to market to those people who fund their own care or risk going bankrupt.’
On self-funders, the committee said it was ‘convinced that the increasing disparity between prices paid by self-funders and those paid by local authorities’ was unfair to both sides and therefore unsustainable.
It raised concerns that some local authorities were able to spend more per head on adult social care than others, leading to a ‘postcode lottery in standards of provision’.
‘Social care funding should not be reliant on locally raised revenue which has little connection to local demand for social care,’ it said.
Responding to the report Julie Ogley, president of the Association of Directors of Adult Social Services, said: ‘We are facing unprecedented demand for social care across England while our resources continue to dwindle.
‘Social care needs to be a priority. The Economic Affairs Committee report rightly recognises the need for urgent financial reform. It’s clear we need urgent and significant investment in the system to ensure access to care and support for those who need it.’
The government has given local authorities access to up to £3.9bn more dedicated funding for adult social care this year, and a further £410m is available for adults and children’s services. It has said it plans to publish its green paper ‘at the earliest opportunity.’