The UK General Election - 4th July 2024


Grand Visions Versus Ts and Cs – The Contested, Overlooked Future of Adult Social Care

Matthew Spencer

Senior Account Manager

In 2019, Boris Johson promised to “fix social care”. 5 years later, it is still very much broken. During that time, we’ve seen the launch of the Government’s People at the Heart of Care White Paper, the rise and fall of the Health and Social Care Levy and a deadline extension for the digitisation of care records. There are over 150,000 vacant roles, with 43% of adult social care providers closing services or handing back local Government contracts because of cost pressures.

With a General Election predicted to take place in six months time, Labour has been very quick to criticise the Conservatives track record on the NHS. Surely social care is equally fertile ground for a media kicking? Apparently not. Rather than putting social care at the heart of their pre-election campaigning; the Labour frontbench has been quiet, almost silent on all things social care. Sure, Shadow Minister Andrew Gwynne MP, has been quick to reassure the sector that they are “first in the queue” for sectoral collective bargaining, but as flagship policies go, it’s hardly a vote winner.

Labour’s concrete policies on social care can be reduced to national terms and conditions for the social care workforce, as part of wider employment rights legislation. Any specifics relating to the unending complexity of the social care sector will likely be delivered through secondary legislation or subsequent Government guidance. Looking at historic parliamentary timetables, it will likely be 2027 before these fair pay agreements come into force across social care. Even then, the question remains as to what impact these Ts and Cs will have on recruitment and retention rates in an adult social care sector where staff turnover rates top 28% a year.

Social care often complains of a Cinderella complex next to the national treasure that is the NHS. There is a real danger that this phenomenon only intensifies under a future Labour Government. While we can expect Labour’s commitment to add 40,000 NHS appointments per week to be repeated ad nauseum over the next six months, social care will be lucky if it gets a footnote. Looking at this political context, it’s hard not to agree with Sir Andrew Dilnot in his call to both political parties to “grow up”, rebuking them in their refusal to talk social care.

For all the complexity of social care, the solution to its workforce crisis is simple: fund local authorities to pay carers the real living wage. Before anything else, workforce pay is the singular issue why carers are leaving social care in droves to work at their local Tesco or Amazon depot. Ts and Cs might support the existing social care workforce, but pay is a key determinant in whether they’ll join it in the first place, and crucially whether they will leave. If Labour is serious about Government, it needs to get serious about local Government finance for the social care workforce. Until then, there will be no resolution for the crisis in social care.

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