And with continuing doubt and uncertainty, particularly over the recruitment of care workers from the European Union post-Brexit, the situation looks set to worsen. The estimated figure of up to 1.4m people currently living without the care they need looks certain to grow. If we think we are in a social care crisis now, then we’re sleepwalking into an even worse one in just a few short years’ time.
At its conference this week, the Conservative government repeated its intention to end freedom of movement into the country from within the EU and only give priority to skilled workers. With care workers currently regarded as low-skilled, this will inevitably restrict the number that can be recruited from the EU.
Currently around 230,000 social care staff in England – 17 per cent of the total – are from overseas, particularly from EU countries. Estimates say the end of freedom of movement could leave the UK short of 380,000 care workers within the next eight years.
People of all ages are requiring more and more complex care. For example, the number of people aged over 65 and needing round-the-clock care is expected to rise by a third to hit one million during the next 20 years. Those aged over 85, and needing round-the-clock care, will double to 446,000. We aren’t anywhere near prepared for that.
In any case, as a care provider myself and with the staffing crisis as it is, I am as worried about covering shifts tonight, tomorrow and next week as I am about decades in the future.
Post-Brexit nightmares are just part of the perfect storm that social care is in. Rapidly increasing demand for care, a sector that has had £7bn cut from it in the past eight years, dwindling care provision and horrendous difficulties in recruiting staff, create the full picture.
The continuing squeeze on local authority budgets is starving social care of the funding it needs to provide care. That means care homes closing down, homecare agencies handing back contracts that are no longer viable to deliver and extra care and day care services struggling.
All that results in fewer and fewer vulnerable people getting the care they need. For a long time now in many areas, only the very, very few, and whose care needs are the most severe, are getting local authority-funded care. Is that any way to treat people?
Also at the Tory conference this week, some £240m was announced to help social care this winter. Welcome money of course, but a drop in the ocean compared to what is needed and just a fraction of the £20.5bn announced for the NHS, even though social care plays a vital role in caring for our most vulnerable.
Supporting social care makes sense, not just from a caring perspective (which is important enough) but from an economic perspective too. Social care employs 1.5m people and contributes £46.2bn to the economy. With better funding, it could contribute even more.
The Government needs to recognise that properly funding social care keeps people out of costly hospital beds and saves the NHS a fortune. Ensuring social care is available when people leave hospital tackles the ‘delayed discharge’ situation. Then maybe we can be rid – once and for all – of the pejorative and much-hated term ‘bed blocking’.
The priority placed on the care of our most vulnerable was clearly evident during the Conservative conference when it was barely mentioned. How I wish the Prime Minister or Health Secretary would take up my offer to visit us and see social care on the front line, to see the challenges we face. I make that invitation again here.
The problem is that social care has never been seen as a vote winner. Maybe, as people wake up to the crisis, it will be next time and people will be challenging politicians on the doorstep and quizzing them on how they propose to handle care. Maybe we should encourage people to stand for election on a social care ticket – now wouldn’t that be progress?
The conference did hear from the Prime Minister that apparently austerity is over and we can look forward with optimism. If that is the case, can we expect the forthcoming and long-promised Green Paper to remove the funding shackles and lift social care out of its malaise?
The Government has to find a solution and quickly. They can start by recognising the job that carers do and stop demeaning it by regarding it as low-skilled. That would at least enable us to recruit from the EU.
But we need a lot more from this Green Paper than that. It needs to offer a sustainable way to fund social care so that people who need care can have it and preferably without the ignominy of having to sell the family home in a panic to pay for it.
It needs to provide fair solutions that bring together health and social care to offer true, seamless, cradle to the grave care.
And it needs to bring sufficient funding into the sector that providers can be paid a fair price for the care they deliver and can in turn pay their staff a wage which recognises their true value. If Amazon can pay their staff up to £10.50 an hour, care providers should be able to as well.
We await the Green Paper. It has been delayed and delayed: never have so many waited so long for so little. We must be positive, but the reality is we have seen a dozen social care ministers come and go in the past 20 years and have seen 13 documents (reviews, commissions, consultations and Green and White papers) in the past 17 years promise much but come to nothing.
This time has to be different. Come on, if austerity is over, let’s start by giving our most vulnerable people the care they deserve.
Mike Padgham is chair of the Independent Care Group based in Scarborough.