What Labour should be planning for adult social care by Gordon Peters- Gordon – a former Director of Social Services in Hackney, is an active member of Reclaim Social Care Network and LSWG supporter

 

Labour Party Manifesto 2019  Adult Social Care Support and Services

Comments of Gordon Peters – former Director of Hackney Social Services and very active within Reclaim Social Care

This LP Manifesto section on social care has to be a good step in the right direction and does begin to undo the real harm and regression in social care and support of the last decade. It is though a disappointment that it has not taken the opportunity – as much of the Manifesto has done for key issues – to re-draw and renew the sector, and turn away from a residual conception of social care.

The National Care Service, as outlined before in the LP Conference document, put into practice by local authorities and partnerships responsive to local circumstances and need, could go a long way towards greater equality and equity in outcomes for people. Being ‘’underpinned by the principles of ethical care and independent living’’ and a commitment to investments to meet need is a substantial statement, but restricted to older people. Why only ‘’an ambition’’ to extend free care to working age adults? Apart from recognition of independent living as an underlying aim there is no specific commitment to support and improve the conditions of life for millions of people with disabilities.The sentence on social care investment ‘’to more than double….publicly funded care packages….improve the standard….and remove the distinction between health and care needs’’ needs disentangling [Bob’s point]. The first part suggests a degree of quantitative improvement on the existing flawed system while the last bit suggests only that health and social need should not be in contention. That would be great but it is left as a tantaliser since the rest of the document does not in fact put social support and care on an equal footing with health. Cradle to grave rights are enshrined in the NHS, and of course need all the protection possible, but the conflict of budgets for Continuing Care and a formal end to means tests in local authority provision are not addressed.

Free personal care, based say on the model in Scotland, is a welcome but partial provision for anyone who requires long stay residential care as food and accommodation for anyone with sufficient means has to be paid for, whereas nursing care is regarded as a NHS function and if eligible then that is free and residential costs paid. The commitment ‘’to develop eligibility criteria…for everyone’’ is important as currently the ever-tightening eligibility criteria are one of the main ways in which austerity has hammered people. But the cap on catastrophic care costs and lifetime contributions does not necessarily even things out for people, and leaves many who are not particularly poor [and hence paid for] nor well off [and able to withstand any long term costs] still worried about what they will be able to afford.

Better contracts for providing care and ethical bottom lines rather than profits will provide a fairer mixed economy of care, and do something about the scandals of large care home owners siphoning off profits to the detriment of both local authorities and people requiring care, but nothing about considering the provision of care as a public function – ‘’growing public sector provision’’ is only saying that the public sector can be helped to catch up in an otherwise market-oriented system. That suggests that the current complicated and very messy array of provision, which so many people have difficulty navigating, will remain. That is no vision for a social support and care system equivalent to our NHS in status and rights. [See for instance the Fully Funded Social Care document, by RSC and Centre for Welfare Reform on this].

There is a loose commitment to ”invest to end the social care crisis’’ which can only be welcome, but the chance to quantify this beyond the restoration of the post-2010 cuts, has not been taken. The Ethical Care Charter gets a nod and along with a guaranteed Living Wage and ‘’access to training’’ for

home care workers is all too necessary, but far from sufficient for a workforce strategy to make working in social support and care the recognised and rewarding task it has to be.
The professional role of social work, the possibilities of community social work, and how social services and rights to self care and support interact are generally missing. These issues may be thought beyond a Manifesto, but what is worrying is an acceptance in this section of it that in effect social care and support remains ‘ancillary to medicine’ [or health professions] and a rather residual function rather than a very significant economic and social investment in wellbeing.

Additional Comments of Sam Baron  Professor of Social Work MMU and LSWG Chair

  1. The Development of the National Care Service lacks specific details. For example whether it is a virtual service led initiative or a physical environment almost like an ‘college’. My concern is that as a ‘service’, which may be a networked service across organisations and service delivery organisations. it may just become an addition to the NHS without its own infrastructure.
  2. There is little mention on prevention and social connectivity which is a cornerstone of adult social care provision. This would be a priority for ASC given the focus of care needs.