The Health & Social Care levy – a once in a generation opportunity

Nathan Hollow

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

It is no secret that the English social care system has long required substantial reform due to the combination of an ageing population, significant workforce churn and persistent vacancy numbers, and a significant decline in local authority finances following a decade of central government austerity. Covid has compounded the need for reform exponentially and, having promised a ‘clear plan’ more than two years ago, the Government finally brought forward their proposals last week.

To avoid repetition, and for those unfamiliar, the BBC has two good explainers regarding the proposed changes and why they are needed:

From the reaction of the sector, it seems many were disappointed with the Government’s announcement, both in terms of its scale and the detail provided. Many have rightly highlighted that the new tax will raise £12bn/year, but only £1.8bn/year will towards social care – far less than the £7bn/year Parliament’s Health and Social Care Committee previously called for.

Despite these challenges, I think there is great cause for optimism. The reaction of much of the right-wing media has shown how exceptionally difficult achieving any kind of funding reform is – and the shrewd politics Johnson deployed by attaching the reforms to ‘fixing’ challenges in the NHS, an evergreen popular topic amongst the electorate.

Whether it’s critique of raising taxes at all, the intergenerational fairness of this specific tax rise, or the effectiveness of the ‘cap’ and ‘floor’ proposals at preventing older people from having to sell their homes, the press has railed against the reforms and many other Government’s may well have been forced into a u-turn in similar circumstances.

Yet, where many other Prime Ministers have tried and failed, Johnson has at least succeeded in delivering legislative change and a potentially significant funding increase.

Furthermore, whilst some bemoaned the lack of detail on what the reforms will mean for the sector – indeed, there has been little specific detail on workforce professionalisation, increasing local authority fees, and many other vitally important elements – this presents a huge opportunity for the sector to engage constructively and fulsomely with the Government and Parliamentarians to develop this detail.

Traditionally, business and industry engage government with an idea and a request for funding, and whilst that idea may well have merit, the financial constraints of many Government departments mean it may never become a reality.

By contrast, we find ourselves in a situation where we know there is a £12bn pot available in 2024, and no specific plans for where or how it will be spent. This affords us a fantastic opportunity to make a persuasive argument to Government, with a specific plan that will deliver tangible outcomes, and that falls within the funding envelope.

Three specific thoughts on how the sector can do this – both through its trade bodies, and as individual companies:

  • Engage with the Care Minister and her team to express an interest in supporting the development of the White Paper, including submitting any specific policy initiatives you would like to see – these should be fully worked through and with clearly noted outcomes.
  • Engage the relevant civil service Directors and request a meeting to discuss ideas and provide technical detail and information that will be useful to the development of the White Paper.
  • Engage with the Parliamentarians, particularly Conservatives, that are the most interested in social care and which will themselves be influential in the development process, and once the White Paper is published. Namely, members of the Health and Social Care Committee, the Department of Health and Social Care Parliamentary Private Secretaries, and any APPG Chairs.

Whilst the situation the care sector finds itself in is far from perfect, we should not let perfection be the enemy of good. After nearly two decades of inaction, change is finally on the horizon and we have a once in a generation opportunity to shape that change.

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