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Ralph Cook

The General Election – another missed opportunity for adult social care

While I would love this election to provide a much-needed opportunity to shift the adult social care system, the main parties have offered little in the way of new thinking. In a recent blogpost featured by the London School of Economics, Melanie Henwood argued that the Conservative Party has unhelpfully narrow-framed the debate to focus on the care of older people, despite the fact that younger adults account for half of social care demand. She also says that the cross-party “fixation” on people not having to sell their homes to fund their care obscures the real question that needs to be answered: “how do we fund adult social care in a way that is equitable, transparent, and sustainable?”

Labour’s commitment to providing free personal care may be politically appealing to many, but it flies in the face of all that we know about improving outcomes for vulnerable people. Incentivising the system to default to providing more care rather than focusing on improving independence is the wrong answer to a complex problem. The Liberal Democrats want a cross-party convention and a cap on care costs. That would mean more talking when what we need is concrete action.

As we have argued many times before (for example in a recent letter to The MJ) more money will help a creaking system but it will not fix it. Complex systems cannot be fixed – there are too many variables and no single person has control. But they can be managed if those involved have a shared ambition and are clear on what good outcomes look like.

The IMPOWER INDEX consistently shows that spending more money does not automatically lead to improved outcomes for vulnerable people – some of the highest performing councils spend much less than others per head.

Instead, rather than just pledging more cash, politicians in this election should have the courage to change the debate. It is time to step away from the easy-but-wrong answers and take the complex-but-sustainable path. They should stop micromanaging the system with daily calls on DTOC and other narrow-framed metrics and start providing the macro strategic leadership that inspires a positive, new future for social care. If there is going to be increased investment in social care, let’s do it on the right things. A good start would include investments in:

  1. Housing – as 85% of people will grow old in their existing homes, there is a need for a national programme to invest in future-proofing our housing stock so that people can continue to live independently
  2. Technology – with more people now stating they would prefer a robot to provide their personal care so that they can retain some personal dignity, we should invest in making the UK a world leader in technology enabled care
  3. Workforce – regardless of technology, the success of future social care will always be dependent upon frontline staff and carers. We must therefore invest in the training and recruitment of staff and support for carers.

On their own, investing in these areas will not solve all the issues facing adult social care but they would achieve far more than the solutions offered by the main political parties. Unfortunately, the opportunity to make progress is not being taken.

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