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The sound of silence

30 July 2018

Last week I sat gripped by the first public outing of the Secretary of State; sitting for two and a half hours in front of the Health and Social Care committee answering questions from the A to Z of health reform, with a limited focus on social care. 

Hats off to Matt Hancock, he appeared poised, calm and extremely clear in his brief – no mean feat – and tribute to a very effective induction programme. And I suspect a wider interest in the arena that this role will helpfully draw on. My predominantly positive response to his appearance can be found here.

So, imagine my surprise when in the midst of all of this – in response to a direct question from the panel – the Secretary of State announced that the green paper would cover ALL of adult social care.

Or to use his words ‘The Green Paper will cover Adult Social Care as a whole’. The clip where he says it can be seen here.

Quite an announcement – and of course yet another change in focus to this long awaited, much anticipated, highly charged green paper. 

Whilst I know Recess has begun, and the parliamentarians are on their jollies, the rest of Whitehall remains in place, and I anticipated a wide flurry of excitement following this announcement. 

How will the parallel work stream that has been exploring working age adults be amalgamated into the existing green paper? (the visibility of this work has been extremely low, therefore it is of concern that there is little to draw on). 

How will the expert advisory group formed in the New Year be amended to ensure the interests of working age adults are represented? (again a group where the output or voice has been less than obvious). 

How will people who use services in either the working age or older people’s category ensure that their voices are heard within the green paper? 

How will any of this be achieved for a paper that is intended to be launched in the Autumn, alongside the 10 year NHS plan, in relation to which we are very aware that significant amounts of work are already in train?

These are very serious questions – and ones that I think we need substantive answers on now, not when Parliament returns in the Autumn. The current silence from the Department on these issues is deafening….

Having listened to Matt Hancock’s quote a number of times more, I am beginning to be more concerned that rather than saying something new, he is an early sign up to the growing mantra around the integration of health and social care. 

His talk of interoperability and integration on a system wide basis, the need to look at health and social care as a whole – are these all watch words to indicate that the sole departmental focus on social care in any forthcoming paper will be on the points where it interfaces with health? Much as it has ever been, I hear the cynics cry, look at the BCF funding, look at the obsession with delayed discharge and the blame game directed at social care, and many more examples. 

However, if the whole future facing ambition of social care, and indeed the creation of a system to fund it is, is geared around the pinch points, the interoperability zones, the connectors, then we will be poorer as a society at the end of it. At the outset, when Jeremy Hunt announced that the Green Paper would be produced alongside the 10 year plan, I was concerned you had the bizarre scenario of a consultative document being presented at the same time as a formulated plan. A 10 year plan that is required to be accepted to secure substantive agreed funding, read alongside a green paper that is likely to tie itself up in knots around the long term approach to funding in a parliamentary climate that is febrile at the best of time, never mind when the politically ‘toxic’ issue of social care funding comes on the agenda. 

It is beginning to feel like there is only one way for this to go…

Matt Hancock can change this, and the appearance in front of the select committee showed in glorious technicolour just what a battle we are up against for meaningful parity of esteem for social care. However, as I noted in my initial response to the select committee appearance: “The regular acknowledgement by the Secretary of State of the importance of social care within his responses was reassuring. However, in both questions and answers relating to Brexit and other issues, it is clear that both the focus of the committee and the department remains firmly in the grips of a health agenda. We need the Secretary of State to take his inclusive approach to social care to the next level and ensure that resources of his department give adequate recognition to the life changing impact of social care."

So until then, watch out cynics - another might be joining your ranks, as like the rest of Parliament, Pollyanna has gone on holiday…..

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