For the past year it has been hard to pick up a newspaper without reading about the government’s plans to reform social care provision in England. The debate reached its climax this July with the publication of the government’s long awaited Social Care White Paper.
The logic for the government’s focus on this area is simple: the numbers of over 65s in the UK will more than double in the next 25 years. The financial consequences of this demographic time bomb are stark; spending on social care will need to triple over the next two decades to keep pace with the greying baby boomers.
The government’s proposals are centred on intervening earlier so as to reduce demand on intensive hospital services; empowering individuals with more information so they can select their own care; establishing national minimum standards; and putting a financial cap on what individuals are expected to pay towards their own care.
A particularly interesting aspect of the government’s proposals is the emphasis on changing how and when the state intervenes. There has been a growing recognition over the last few years that the government currently intervenes too late and that this is both more costly for the State and harmful to the individual.
For example, the cost of treating a fractured hip costs the NHS £28,000 – five times the cost of adapting a home with adequate mobility products that would potentially prevent an accident or fall occurring in the first place.
Recent research conducted with the London School of Economics’ Personal Social Services Research Unit in partnership with the British Healthcare Trades Association underlines this point. According to their investigation, for every £1 spent on adaptive technologies in the home, there could be a net benefit to the taxpayer of £1.10. With 568,000 people over 60 requiring an adaption in the home, if this need was met in full there would be a net benefit of £625m.
More importantly, individuals would have more access to the preventative technology that can enable them to live fuller, more independent lives within their homes, as opposed to a hospital or care home. Beyond all politics and squabbles over funding, this should be the main driver for government.
Yet despite the Health Secretary, Andrew Lansley declaring that his White Paper represented “the most radical reform of the social care system in 64 years”, and nobody – Labour or Conservative – doubting the progressiveness of the reforms, there is still one outstanding issue: funding.
The decision on funding will fall to the Chancellor in the 2014 spending review – meaning the vision is effectively not fully costed. At a time of recession and government austerity this is clearly a big issue.
Let’s hope Lansley and Cameron have the vision to solve the funding issue and provide the foundations of a system fit for purpose – now and in the future.