However, even though this is our largest budget – and we have other important commitments, to children and parents and to road users, for example – we still have had to make savings. While no-one would have wanted austerity, it has forced us to look critically at how we spend taxpayers’ money and how it can be spent better.
So, we have focused on prevention: supporting people to be independent in their own communities, building 22 extra care housing schemes, with up to ten more in the pipeline. And we have continued to invest in the social care workforce through training and recruitment initiatives with care sector partners.
We have many dedicated colleagues, both within the county council and the wider care sector, who provide great support to people day in, day out. One of our care workers talks about ‘needing big eyes’ to work in social care, because you have to look beyond the immediate tasks to the person’s story.
Sometimes, we know, we could improve what we do – part of that, increasingly, is due to the strains that the system faces; challenges with recruitment, ageing property and the logistical difficulties of delivering care to some of the most remote communities in the country.
In short we have done much to spend our money carefully and effectively. But still social care faces an existential crisis due largely to an ageing population, a welcome increase in life expectancy of younger adults with disability, an increase in mental ill-health and the fact national funding and policy has not kept pace with these changes.
Social care is now reliant on a fragmented cocktail of funding: variable personal fees, which make it difficult for individuals to plan for the future, council tax, and income tax. And Whitehall is littered with various reports which have failed to provide the comprehensive reform that is so badly needed.
That’s why we support two recent publications – the Local Government Association’s strategy, The Lives We Want to Lead, and the County Council Network’s report Sustainable Social Care: A Green Paper that Delivers a New Deal for Counties, in anticipation of the Government’s forthcoming Social Care Green Paper.
We have long called for a twin-track approach to social care reform, combining a sustainable funding settlement with a fairer system which enables people to plan for their futures. We are now calling on the Government and all partners to adopt a 12-point plan which includes:
Long-term funding for social care, including the short-term monies which have been passported to councils via the NHS;
A fair system for allocating funding, which takes more account of the different needs and higher transactional costs of providing care, in rural and coastal communities;
Extending National Insurance to people who are working beyond the national retirement age, combined with an additional premium for people 40 and over;
A system which provides a floor and a ceiling for how much any individual has to pay towards care costs during their lifetime, so that families can plan with certainty;
A much more preventative approach to underpin joint working between the NHS and local councils;
A digital first strategy to promote personal independence and to improve productivity and efficiency;
Changes to housing policy, so that more bungalows are built and more new houses meet ‘lifetime’ living requirements;
Reform of VAT to support care homes;
Bursaries for nurses and other care staff to address national and local staffing shortages;
A post-Brexit immigration policy that assists with the vital skills that we will need;
A radical re-think of how this country helps the one in eight of us who are carers;
Greater encouragement for people to make Advanced Decisions, Living Wills and Lasting Power of Attorney statements about their future care and welfare.
Over the past 10 years, election campaign debates about the ‘death tax’ and ‘dementia tax’ have demonstrated the political difficulties apparent in reforming social care.
We therefore believe comprehensive reform of social care requires a cross-party approach to achieve an enduring settlement that works for people who need care and the organisations that provide care;, and is fair to the public as a whole who pay for that care.
Coun Michael Harrison is North Yorkshire County Council’s Executive Member for Adult Social Care and Health Integration.