Social care doesn’t need another review, it needs proper funding - Ros Altmann

After years of promising radical reform, waiting, hoping and even legislating for significant changes, we are back to square one. The system is broken and does not need yet another review. It needs action.

Any meaningful reform will undoubtedly need more funding in the short-term, to help save money in future as more older people need care. Yet, Baroness Casey has been told she cannot recommend anything that will entail additional spending. This undermines the chances of any successful outcome.

She has been asked to consider what model of care is needed to address demographic change, how services must be organised to deliver this and how to deliver a fair and affordable adult care system.

For nearly 20 years, it has been well-documented that the present system is unfair, but is only unaffordable because councils have been charged with paying for care, but not been given the resources with which to do so. Without new funding, either from redirected NHS money, or extra local authority spending, the Commission's task seems impossible.

Policy change such as a national care service, that dovetails with the NHS, is likely to cost money initially. For example, at present, there are no incentives for councils to take people out of hospital quickly – indeed councils, patients and their families have a clear financial reason to avoid hospital discharge and try to reject applications for care.

Paying councils or care providers to spend money on preventive measures, or accelerate taking patients into less expensive, non-hospital settings, would reduce NHS bed-blocking and backlogs, but it could also cost extra in the short-term, although saving money in the longer term.

Perhaps today’s politicians, mindful that social care proved a political minefield in general elections both for Labour, under Gordon Brown in 2010, and the Conservatives, under Theresa May in 2017, prefer to just pass the baton to a future Government. Perhaps they also calculate that elderly and disabled people are unlikely to take to the streets to protest and their families are too busy trying to look after their loved ones to fight.

Unfortunately, as the Government grapples with the failing health service, perhaps it does not properly recognise that the NHS and social care are two sides of the same coin. Cuts to social care over the years have left people without early interventions that could prevent future falls, or hospital admissions.

Such short-sighted thinking has seen more patients in NHS hospitals unnecessarily, unable to leave because they are awaiting the social care they require, but which local authorities cannot deliver, due to budget constraints.

Baroness Ros Altmann is a pensions expert and independent peer.