Will the plans usher in a revolution in the way we care for older adults? Or will they be the latest in a long line of failed attempts to reform the failed system?
The Casey Commission, set up to map a blueprint for a National Care Service and due to report next year, has begun its work under intense pressure from Carers Trust not to “squander the opportunity for once in a generation”.
Ministers have given it sweeping terms of reference to shake up adult social care.
The starting point, as defined by the government’s terms of reference, will be “a national conversation to build consensus with the public on how best to meet the current and future needs of the population.”
More power to carers
Then, the commission should produce “tangible, pragmatic recommendations to be implemented in a phased way over a decade. It will aim to make adult social care more productive and preventative, and to give people who draw on care, and their families and carers, more power in the system.”
The terms of reference continue by saying, “The commission’s work will focus specifically on existing funding for local authority adult social care services, together with NHS funding for intermediate care. It will seek to identify what changes can be made to funding flows and accountability mechanisms to improve quality and productivity.”
It also has the instruction to “recommend reforms that help the government to hit the 18-week standard for elective care and deliver a neighbourhood health service – by reducing unnecessary hospital admissions and addressing delayed discharges.”
No extra money?
But the government has warned that any proposals “must remain affordable, operating within the fiscal constraints of Spending Review settlements for the remainder of this parliament.”. In short, there will be no extra cash before 2030.
The second phase will make longer-term recommendations for transforming adult social care, reporting back by 2028. This should build on the commission’s medium-term recommendations to look at the model of care needed to address demographic change, how services must be organised to deliver this and discuss alternative models that could be considered in the future to deliver a fair and affordable adult care system.
Critics and sceptics have already hit out.
Last chance for reform, Carers Trust warns
There have been many reviews of social care over the years – this must be the last one. The government has a once-in-a-generation chance to fix the system. It must not squander that opportunity.
Social care has been in dire need of reform for two decades. While successive governments have failed to act, millions of unpaid carers have been left to plug the gaps by looking after friends and family at home.
Many are at breaking point and being pushed into poverty by having to give up work because of their caring responsibilities.
Carers and the strained local organisations that support them simply can’t hold out much longer. They need meaningful reform urgently.
Silver Voices attack ‘blank signpost’
The older people’s campaigning organisation Silver Voices attacked the government for failing to explain what it means by ‘a national care service’.
“Social care reform is at a crossroads, but the signpost is blank in all directions, it said, leading to a ludicrous situation where the Commission has been charged with setting out how to implement a national care service but with no explanation from the Government on what they actually mean by a ‘national care service”, they say.
Silver Voices say that this could be anything from a stand-alone national body on par with the NHS, to the current failing model, run mainly by local authorities, with a few national performance indicators and minimum standards added on.”
Social care on the brink of collapse
Silver voices warn:
Social care is in a state of collapse throughout the UK and is crying out for political direction from the Westminster Government.
We need some consistent principles to be applied across the UK, with the central taxation funding to match, in the same way that the NHS operates across our islands.
It warned that the NHS would never escape its “constant state of crisis” while hospital beds and emergency services are placed under so much pressure by a lack of social care in the community
Three key questions
Silver Voices say that ministers need to answer three basic questions:
- Does Labour envisage a national care service as a stand-alone organisation on par with the NHS, or if not, what form will it take?
- What broad objectives will a national care service be set up to achieve?
- Does Labour still believe that social care should be provided on the same basis as the NHS, i.e. free at the point of use?
Silver Voices warned that until those questions were answered ‘Baroness Casey has an impossible task, being required to make recommendations on implementing an undefined organisation with undefined service objectives.’
It will be like trying to juggle with a blancmange.
