How we pay for and provide care and support to people in England is one of the greatest unresolved challenges this country faces. More than 1 million people are forced to struggle every day without the social care they need – this is simply unacceptable for one of the world’s richest economies.
The outgoing Prime Minister came to power promising to fix the crisis in care. She failed. It is now more than two years since the government pledged to release a social care green paper and we are yet to see it.
Despite best intentions, this is an issue that successive governments have failed to address for decades. The desire is often there but the absence of cross-party support always derails well-considered reforms – often during the white heat of an election campaign.
And this remains one of the central barriers to delivering a more sustainable social care system, backed up by a long term financial settlement, that lasts for generations.
Minds are clearly elsewhere but we need our political leaders from across the divide to come together to find a solution for the sake of hundreds of thousands of vulnerable people.
Those same political leaders know all too well the scale of the problem and the extent of it has played out vividly on our TV screens in a powerful investigation by Panorama called Crisis in Care.
The good news is that there are no shortage of ideas on how to solve the problem but what is lacking is the political consensus to agree what the ideal solution would be.
The NHS Confederation, which has brought together 15 national health organisations to make the case for a sustainable social care system, wanted to test the views of MPs. They are crucial to unlocking this issue and that’s why our Health for Care coalition commissioned the independent polling company ComRes to understand where parliament stands on social care.
The results were illuminating, with three quarters of MPs (76 per cent) saying there is now a crisis in care in England, including more than half (58 per cent) of Conservative MPs.
Three out of five politicians say people in their constituencies are suffering because of cuts to social care. And two thirds (65 per cent) of MPs say the number of people in their constituencies coming to them with concerns over social care has increased during their time in office, with nearly half (46 per cent) saying it has increased significantly.
Concern was highest among MPs in the north of England where two thirds (62 per cent) of MPs strongly agreed that their constituents are suffering because of cuts to care.
However, while there is consensus on there being a crisis in care, there is no consensus on a policy option that would unite MPs.
Of the funding options likely to feature in the upcoming green paper, we see a fairly even split between support for introducing free personal care (21 per cent); an auto-enrolment insurance system (20 per cent); a cap on costs and revised ‘floor’ to the means test (19 per cent); and improving the current system (18 per cent).
Along party lines there is even further difference in opinion. Labour MPs are much more likely than Conservatives to support the introduction of free social care (40 per cent vs 4 per cent respectively). Conservative MPs are much more in favour than Labour MPs of an auto-enrolment insurance system (30 per cent vs 8 per cent respectively), or a cap on costs and a revised “floor” to the means test (27 per cent vs 11 per cent respectively).
While this is not surprising given the two major parties’ differing approaches, it does suggest a political consensus will be harder to achieve.
What is clear from the views of MPs is that there is a crisis and it needs to be tackled. There is no doubt that finding a sustainable, long-term solution to how we pay for and provide care and support to our most vulnerable people is one of the greatest challenges we face.
We need to deliver a more sustainable social care system, backed up by a long term funding settlement, the right workforce and a stable market of providers.
It is imperative that the next Spending Review, potentially in autumn 2019, includes a funding increase – research that the NHS Confederation commissioned the Institute for Fiscal Studies and the Health Foundation to undertake in 2018 recommended this be set at 3.9 per cent per year.
We all know the extent of the problem and we know there are credible ideas out there to solve it. Now is the time for MPs of all parties to work together to agree a solution that ends the unfairness faced by record numbers of people left to struggle each day without the care and support they need.
We cannot allow such a critical domestic issue as this to be left ignored for yet another year.
Niall Dickson is chief executive of the NHS Confederation.
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