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Party is over…. time for action….

8 October 2018

Over the last two weeks we have had more than our fair share of announcements, counter announcements, policy positing, high drama and undisguised broadsides. However, now the party is over – there is an opportunity to look at what was said at both the Labour and Conservative party conferences and see what they might mean for social care. 

In Liverpool, there was a strong acknowledgement in the leader’s speech of the problems facing social care, talking of “…..the scandal of the Tories’ £6 billion cuts to social care, leaving 400,000 fewer older people receiving care. Too many of our older people condemned to live alone and isolated, often ending up at A&E through neglect, then unable to leave hospital because it’s not safe for them.

In connection with this narrative, there was a very welcome media played focus on the significant reduction in community services – particularly day centres – which recognised their central role in combatting social isolation and sustaining a preventative independent based provision within communities.

Then in John McDonnells speech, some further indication of how Labour in power might address some of the workforce challenges, announcing promises to:

  • Ban zero hours contracts.
  • Setting a real living wage of £10 an hour.
  • Determining wages by sectoral collective bargaining.

In his platform speech, John McDonnell returned to key elements of last years’ manifesto, talking once more about nationalisation, and bringing water, energy, Royal Mail and rail into public ownership. However, there was no specific mention of the pathway towards a national care service. That said, he has launched a large-scale consultation on democracy in our public services. Whilst it does not specify particular industries, it does look at what different models of public ownership are being considered, and how models such as cooperatives and not for profit organisations are a key part of ensuring that public services are accountable to the communities that they serve.  

The conservative party conference did include specific announcements related to social care, most notably the Secretary of State for Health and Social Care promised an in year funding boost of £240m for social care- aimed once again at facilitating rapid discharge from hospital. However, this welcome funding pot aside, the narrative around the NHS continued to dominate all discussions; the early championing of social care by Matt Hancock seems to be less visible as the months go by. In his conference speech, albeit starting from a very personal NHS orientated premise, his first foray into referring to social care went something like this “Social care is under pressure too. I know the pressures and we’re going to address them because I want us to make the NHS the best health service in the world”.

Mmmm……

He then went on to say:

“But I want to help the NHS through this winter too…..And I can announce that today I am making an extra £240 million available to pay for social care packages this winter to support our NHS. We’ll use this money to get people who don’t need to be in hospital……but do need care…… back home……back into their communities……so we can free up those vital hospital beds…… and help people who really need it, get the hospital care they deserve.”

Well…. There is a definite sense of where the priority lies….

Little bit later in the speech he gets back onto social care

“We need reforms of social care too, to make it sustainable for the long term….Reform of social care is long overdue…… and we’ll publish a paper later this year setting out the progress we can make to give all people confidence and dignity in old age. And of course, we can’t do any of these reforms without our GPs…..”

Sorry GPs, but what about the number one priority, the workforce? Where is the recognition of the pressure of the workforce in social care? Where is your focus on priority number two, how are we tackling the need for wholescale investment in technology in social care?

And I have to say it’s beginning to look a lot like the third priority of prevention actually meant prevention of pressure on the NHS – not prevention supporting long-term independence of people by effective social care interventions.

Whilst I know there is only so much one can pack into a speech, to give the two parts of your brief something more akin to shared billing would enhance confidence. Don’t forget social care is good for people; society and the economy. It is insulting to the 1.6 million people who work in it, and the millions who receive support from it, for it to be represented primarily as a prop for the much-loved NHS.

As for the Green Paper, the headline announcement on that appeared to be from the side, with Damian Green publicly predicting that any proposed funding solution would not be implemented until 2022 – referencing lack of parliamentary time.

Recognising the role of social housing

On a more positive note, the announcement by the PM that the cap on the Housing Revenue Account would be lifted signified another important recognition of the role of social housing in addressing key community issues. As localised commissioning strategies adapt to the ‘new normal’ of significant restrictions on localised funding, which we know (budget announcements aside) will reduce further in 2019-20, the drive to incorporate greater extra care and sheltered/supported housing in response to their greater capacity to build will be strong.

The potential for local plans to highlight both older peoples housing, and their responsibilities in relation to Transforming Care will make for some interesting local decisions. Council house building has fallen dramatically over the last 30 years, hitting an all-time low of only 50 properties being developed in 2000. Last year saw this figure rise to 3000.

I think we will need to look to those councils who have already started to build again to see some early indications of whether this new build potential might enable a focus on both older and disabled communities and how they will engage in partnership with care provision to make these viable options for sustaining independent living.

Austerity is over – really?

The statement that austerity was ended raised quite a cheer in the Conservative Party Conference audience; however, I think for many in care, they will relate to this astute article by Mike Padgham in the Yorkshire Post – ‘If Austerity is over, that’s news to carers’.

Festival of Great Britain

Finally, I was interested to hear the ‘rousing’ element of the PM’s speech –that once again – the notion of year-long festival of Great Britain and Northern Ireland to signify regeneration and renewal was on the cards.

I mention this in the context of social care; the timing should be of great interest to those working in older peoples services because of the potential tie in with the Industrial Strategy focus on Healthy Ageing.

The long awaited prospectus for the Healthy Ageing Grand Challenge (due initially in May and now planned for October) will clarify how plans to stimulate innovation around enhancing quality of older life are to be addressed. The £98m fund will want to see significant transformation over a two-year period; I will certainly be seeking to see if the outcomes of this can reinforce the Industrial Strategy ambition and be used to showcase the UK as a leading global force in ageing.

If there is a ‘festival site’ option, then we should be arguing for the whole site to be earmarked a truly integrated village community that celebrates our learning about intergenerational working, community assets and village clusters of care services. This would ensure the legacy of any such Expo continues to expand our understanding of how we can really create a built environment for healthy ageing at the scale that our demography demands.

And on a final note, I am sure the closing speech of the Conservative party conference will have given us all something to think about. For me, I noted the need to update my Playlist for Life; Dancing Queen has, I’m afraid, lost it’s sheen. But thankfully there are plenty more camp classics out there to keep me happy into later life….

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