Will the Green Paper Lead to Green Shoots?

Nathan Hollow

Board Director - Head of Health and Social Care - Head of South West

Will the Green Paper Lead to Green Shoots?

A funding shortfall in the Armed Forces; a funding shortfall in the Police force; a funding shortfall in schools; and a funding shortfall in the NHS.  That’s four major issues in the Prime Minister’s in-tray that would stretch any government, yet that’s without even touching on terrorism, ‘generation rent’, air pollution, prison reform, benefit cuts, and an independence referendum in Scotland.

Oh, and of course Brexit – a task of such scale that, according to some experts, simply repatriating every law from the EU could take up to a decade – and finally, the topic we’re all most concerned with, the crisis facing state funded social care service.

The signs of positive progress are beginning to appear. Having ignored the sector in last year’s Autumn Statement, the Chancellor’s Spring Budget brought some good news in the form of £2bn of additional funding over three years, half of which was arriving upfront in 2017/18, as well as confirmation of a Green Paper later in the year on options for long term funding reform.

This is good news, yet there is still a long journey ahead before a solution is agreed and implemented – let’s not forget that since 1997 there have been four independent commissions on sustainable social care funding whose recommendations were not implemented.

A Green Paper – Parliamentary language for a paper setting out ideas for discussion or proposals which are still at a formative stage – is just the first step in a legislative process that will likely take years to complete. However, when the paper is finally published it arguably needs to outline two funding solutions for social care, not one.

The first solution needs to resolve the immediate cost pressures facing providers, and to support some of the 1.6 million people with a care need but no care package to get the help they need. This money is needed now, but may consider it unfair to raise it through general taxation which would affect a younger generation of people who are already destined for worse savings and pensions, lower salary growth, and significantly later (if at all) entry into the housing market, compared to the experience of their parents or grandparents.

Alternatives include a new income tax bracket based on age, additional levies on second or high-values homes, or means testing and redirecting money from the winter fuel allowance and other pensioner benefits.

A second solution is needed to fund care services for the long-term so that when the younger generation does reach the age when we need care, the money is there to provide it. This could be through a life-time care ISA or a new type of pension product backed by the government, both of which could be started now but not pay out for another 30 to 40 years to allow for investment growth.

What should not feature in the Green Paper is the continuation of the Council Tax Precept, principally because it is a poor, and unfair, way of raising money. Local authorities in poorer areas with a low Council Tax base raise much less money – between £5 to £13 per adult – through the precept than richer areas. The areas least able to raise money also happen to be the places with the highest levels of publicly funded social care – a double edged sword for those Councils.

The current pressures on government time and financial resources are of epic proportions. Brave, innovative, cross-party action is needed to find these two solutions to the funding crisis in social care. It is therefore crucial for the sector’s leaders to continue to champion its cause and ensure its voice is heard at the highest political levels. To do this, the sector must start utilising the voices of the millions of people who use a care service – residents, loved ones, employees – to demonstrate how social care is the most important item in the in-tray, and must not be placed at the bottom of the pile as has all too often been the case in the past.

This article originally appeared in the April edition of Healthcare Business.

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