Andy Burnham is correct to place social care on the coronary heart of the political debate. He’s additionally proper to say politicians shouldn’t “flinch” from troublesome conversations about funding.
But when social care reform turns into one more argument about who pays, we’ll miss a a lot larger downside hiding in plain sight.
The uncomfortable fact is that we’ve constructed a social care system that spends an excessive amount of time deciding who doesn’t qualify for help.
Funding issues. There isn’t a query that native authorities want larger sources to satisfy rising demand. However the resolution to a social care system that works for everybody goes past funding alone.
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At Entry Social Care, we offer free authorized recommendation to individuals making an attempt to entry the help they should reside independently and take part absolutely of their communities. What we see again and again is a system that creates boundaries to care by rationing.
That isn’t as a result of social employees or council workers don’t care – removed from it. It’s as a result of monetary pressures have formed a tradition the place the precedence typically turns into managing demand slightly than selling wellbeing.
When budgets are stretched, the inducement is to limit entry, tighten eligibility and focus sources on these in essentially the most acute want. Assist that would stop issues from escalating is delayed or denied as a result of the system is below strain to focus on fast crises.
The result’s a vicious cycle. A disabled one who may stay in work with the suitable help loses their independence. An older individual struggles at residence till a preventable fall lands them in hospital. An unpaid carer carries increasingly more duty till they attain breaking level themselves.
These outcomes are unhealthy for people, unhealthy for households and, finally, unhealthy for public funds. But too typically they’re handled as inevitable.
What makes this significantly troubling is that it runs counter to the rules on the coronary heart of the Care Act. The laws is constructed round wellbeing. It recognises that social care ought to assist individuals preserve dignity, independence, relationships and management over their very own lives.
A system constructed round wellbeing can’t be judged by how successfully it retains individuals out. But that’s typically what occurs in follow. Cycles of assessment, reassessment and cuts can develop into workouts in decreasing help slightly than understanding what individuals must reside effectively.
For this reason I welcome Andy Burnham’s intervention. Social care has too typically been handled as a difficulty that may be postponed till one other day. It’s encouraging to listen to a politician with management ambitions recognising it as one of many defining challenges of our time.
However actual reform requires greater than a brand new funding settlement. We want a deeper cultural shift away from rationing and in the direction of prevention. Away from gatekeeping and in the direction of enabling individuals to reside the lives they need. Away from asking how many individuals we are able to hold out of the system and in the direction of asking how many individuals we may help thrive.
Politicians are proper to debate how social care must be funded. They need to. However additionally they must reply a extra elementary query: what’s social care truly for? As a result of till we cease measuring success by how many individuals we are able to exclude, we’ll by no means construct the system individuals deserve.
