The UK General Election - 4th July 2024

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Social Care in the Shadow of the NHS

Jessica Peddie

Account Manager

In the midst of a general election campaign, the spotlight is well and truly on the National Health Service (NHS). The first few weeks of the campaign have been characterised by impassioned promises from all ends of the political spectrum to cut waiting lists, increase access to GP and dental appointments, and improve services. The NHS may well be the battleground where this election is won and lost. Yet, when it comes to the UK’s main parliamentary parties, an equally critical issue may continue to face relative neglect: social care.

The social care sector, encompassing a range of services to support individuals with disabilities, mental health needs, and the elderly, is estimated to be the UK’s biggest employer at an estimated 1.79 million total roles. But the system itself is at breaking point, facing untold pressure and strain from increasing demand, chronic underfunding, and a workforce situation teetering on crisis.

Social care supports some of the most vulnerable members of our society and is one of the most relied upon sectors in the UK, yet it consistently fails to capture the political attention it deserves and, consequently, the long-term policy commitment it so desperately needs.

 

The Reality

To appreciate the gravity of the situation, let us consider the facts. The UK’s population is ageing, and the number of people aged 65-79 is predicted to increase by nearly a third (30%) to over 10 million in the next 40 years. The number of direct payment users of social care alone is predicted to rise 63% by 2035. This demographic shift will create inevitable strain on our entire health and care system, and demands a robust, sustainable, and well-funded social care sector.

The social care workforce is another concern. Working in care is a difficult job and care workers, often undervalued and arguably underpaid, play an invaluable role in improving the quality of life for the people they support. Yet, after years of social care reform being kicked into the political long grass, the sector remains plagued by high turnover rates and consistently struggles to attract and retain staff.

 

The Perception

Neglect of social care in political debates is hardly a new phenomenon, with the issue often falling victim to topic avoidance or simply being paid lip service during broader discussions of the country’s health and care system. Our National Health Service is rightly championed as a meaningful and socially necessary institution, but it casts a long shadow in which social care seems doomed to dwell.

This imbalance extends beyond campaign rhetoric; however, it continues to reflect much deeper systematic problems.

One reason for this could be the complexity of the social care system. While the NHS is a multifaceted beast with its own complicated and layered ways of operating, most people interact with it on a very tangible level – at their GP surgery for an asthma check-up, their pharmacy picking up antibiotics, A&E for a broken arm. Whereas in the case of social care, for many the system does not exist beyond the care home where they might visit a grandparent.

The reality, however, is that most of us will interact with social care at some stage in our lives. The system is also fragmented and hard to conceptualise outside of the context of personal experience. Delivered through a mix of public, private, and voluntary providers, and funded by a combination of local authority budgets and private contributions, this complexity makes it a less attractive subject for the simplified narratives favoured in election campaigns.

 

The Future

So far in the campaign, any social care policy outlined by Labour has tended towards a focus on workforce and their New Deal for Social Care Workers, which commits to ensuring they are treated with ‘dignity and respect’ and is supported by a Fair Pay Agreement.

The Conservatives have leant on the promise of coming reform, though their previous social care proposals, including raising the upper means-test threshold for entitlement to state funded care from £23,250 to £100,000, have been repeatedly delayed and currently stand to be introduced in October 2025. The latest data suggest 62% of over 75-year-olds are delaying financial plans for residential care until such reform appears.

While the Green Party have committed £20 billion of their proposed £50 billion healthcare package to social care, they are yet to offer a clear outline of where exactly this money will be filtered. The Liberal Democrat’s manifesto has pledged to raise the minimum wage for care workers by £2 an hour, overhaul the carers allowance system to create fairer assessments and support for unpaid carers, and fund free personal care for adults in England to the tune of £2.7bn.

As the first major party to articulate a specific plan for social care, this could represent a significant step towards creating a more equitable system for those who need care support, but it remains unclear whether it would be enough to fix a vast, vital, and fundamentally broken system.

With several of the main party manifestoes due to drop in the coming days, those involved in social care will be looking for a comprehensive, long-term strategy for the sector, including sustainable funding, workforce investment, and improved integration with health services.

A continued political sidelining of social care will have profound implications. When social care fails to meet demand, the burden shifts swiftly onto the NHS, straining a service already rife with its own challenges. Hospital beds are occupied with people who could be better cared for at home or in community settings, loved ones are made to take on unpaid caring responsibilities alongside part or full-time work, and individuals who rely on these services are left without the support they need to live safe, healthy, and independent lives.

The human cost of inadequate social care reform is impossible to calculate and the system’s failures ripple through communities, homes, and families, affecting millions.

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