Reflections on ADASS Summer seminar and the session I co-presented: ‘How to deliver good adult social care - despite Covid’
The fact that the first Citizen’s Assembly commissioned by Parliament is on the subject of adult social care funding shows that this issue has become one of the top complex social problems of our age.
The Assembly, details of which were first revealed on 22 April, forms part of a joint enquiry (by the Housing, Communities and Local Government select committee, and the Health and Social Care select committee) into the long-term funding of adult social care. Over the coming weeks, the opinions of 50 randomly-selected voters will be sought after they have heard evidence from a panel of experts about different funding options.
Noise from the public over the crisis in social care funding has been steadily increasing in volume, despite measures such as the additional £2 billion of funding over three years announced in March 2017 (see our recent report for an analysis of the impact of the £1 billion that has already been spent).
Until recently, many believed that the primary funding issue was the fact that ‘the public doesn’t value social care enough’. The view was that there had not been sufficient public pressure to result in more funding for social care (in contrast to public pressure for greater funding for the NHS).
There have been various attempts to address this – but ironically, what did the job most successfully in the end was the 2017 General Election. The strong public response to the Conservative party’s manifesto plans to revamp social care funding led them to drop those plans, massively raising the salience of the issue in the process.
Whatever you thought of the Tories’ proposed funding changes overall, from my perspective they did include common sense attempts to simplify a complex system. The way that even these simple changes were explained in the media (and the strong sense of public outrage that followed) showed how hard it is to understand the current system, let alone any attempts to reform it.
So following this turning point we are now in a different situation – the issue is now ‘the public do care about social care, but don’t understand it’.
That is why the biggest challenge for the upcoming Green Paper is not about policy options, but about making social care make sense to the public. That is why we have had a sequence of green papers, white papers and commissions with nothing managing to stick. Could that happen again? Absolutely.
I believe that four steps are needed to reframe the debate and avoid history repeating itself:
- Acknowledge that public understanding is at the heart of the issue – it is not just about coming up with a good policy. The Citizen’s Assembly might offer some insights here.
- Strengthen consensus that the current social care system doesn’t make sense and is unfair. The fact that it is not financially sustainable isn’t in question. Can we take a risk in building understanding that it isn’t fit for purpose regardless of the amount of money we put into it?
- Take the chance to use the finely-honed skills of co-production within the sector to make a difference at a macro level.
- Learn from the evidence on how public perceptions are actually changing. If someone had told me a few years ago that 95% of us would be paying 8% more council tax by 2018, with the additional money going to social care – and virtually no public push-back – I would not have believed it.
The debate has moved on. It turns out we do believe in social care – it’s just that the social care we believe in is still up for grabs.