In Focus: Protecting the nation  

Social care: learning from the past and looking to the future

  • Communicate historic developments around social care provision
  • Explain the current political situation around social care
  • Identify ways social care funding could be tackled in the near future
CPD
Approx.30min

The question of where the money should come from to improve social care is not easy to answer, particularly for politicians who are keen to keep their seat at the next election.

Touchy subjects

Ahead of the 2010 general election, which Labour lost, then-PM Gordon Brown was reported to be considering a £20,000 compulsory inheritance levy to boost social care, which was quickly branded a “death tax” by opponents.

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In 2017, the social care issue was widely considered to have damaged support for the Conservatives after Labour branded plans announced by then-PM Teresa May (which initially did not include a cap on costs) as a “dementia tax”.

Perhaps an even more egregious electoral mistake was her idea that the value of the home should be included in the means test – it is currently ignored in certain circumstances.

The idea of being coerced into selling homes to pay for care is a touchy subject.

In 1997, new PM Tony Blair said: “I don’t want (our children) brought up in a country where the only way pensioners can get long-term care is by selling their home.”

David Cameron said making people use the value of their home was “cruel”, and Boris Johnson promised his plans would ensure it could not happen.

His alternative was for a social care levy to help fund a care cap.

That idea did see the light of day as a 1.25 per cent temporary increase in national insurance rates, a move scrapped within months when Liz Truss briefly took over the top job.

The past shows us that there are many ideas on how to improve funding for social care – each has pros and cons and will favour some groups over others.

Very few ideas floated have proved to be popular.

What has been missing is the political will to push through the criticism. With a huge majority, could Kier Starmer’s government unblock the logjam?

It is what it is

There is no central government budget for adult social care in England. Those who can afford it have to pay their own costs.

Public provision is mainly funded by local authorities through a social care precept on council tax bills, but the ability of any council to raise revenue may not match demand for care services in their area.

In recognition of the cost pressures, the government has provided additional ad hoc funding.

The Better Care Fund is a pooled budget shared by local authorities and the NHS with the goal of better integrating services.

Theoretically, local authorities should have been preparing for the planned reforms in October 2025. 

Council leaders had warned that tens of billions of pounds would be needed over the next decade to push ahead with the reforms, none of it accounted for in current spending plans.