The motto of Queen Elizabeth I was the Latin phrase ‘semper eadem', meaning ‘always the same'. Subsequent Governments have also used this in relation to how they have treated social care.
Many people viewed the arrival of a new Labour Government with a huge majority as something that would deliver a better future for social care. They felt this Government not only had a commitment to social care but also the necessary Parliamentary majority to deliver a long-term and sustainable future.
How wrong we all were. Within a few short weeks of taking power, this Government signalled they were not only going to follow the traditional course of many administrations on social care, which is to ignore it, but worse, we were seeing announcements harmful to the sector.
The first was the reform agenda being scrapped and this took us back to where we were before Sir Andrew Dilnot developed his proposals. This decision put us back at least 10 years. However, this was the first of several announcements that would set the tone for how this Government would treat social care.
Hot on the heels of abandoning reform, the Government decided to abolish the workforce development fund. There have been years of pronouncements from Labour during their time in opposition that we needed to professionalise the workforce and one of their first acts was to pull away some of the resources that were dedicated to this specific purpose.
Then came the Budget and the increase in employers' national insurance (NI) contributions, which has put millions of pounds in extra costs into an already cash-strapped sector. This would be just about acceptable if our major customer, the Government, was prepared to meet the extra costs, but they have steadfastly refused to do this. They have thrown an inadequate amount of extra funding at local authorities, which will in no way compensate for the extra costs of NI changes. This money was also to be distributed across both children's and adult social care services. There is reliable data that the funding gap in social care is well north of £3.5bn but the Government's response was a £600m grant to local authorities. This will not touch the sides in terms of the needs of the current provision, let alone deliver for the future.
Another unexplainable thing the Government has done is constantly separate social care from the NHS while talking endlessly about integration. You will never have an integrated system when you throw an extra £23.5bn into one part and completely ignore the other.
During the Christmas break, the Government announced Baroness Louise Casey was going to head a commission looking at the Future of Social Care. There is an expectation that she will report in 2028. I presume this will be timed to ensure her report is not delivered ahead of the election, and if it is, we will have another set of promises that are not delivered.
Social care is an important part of the national infrastructure and the Government should understand it is also interdependent with the NHS. It is impossible to solve one challenge without addressing the other. It was also interesting to note that last year, one of the NHS's lowest take-ups of social care beds was seen and next to none have been commissioned.
However, during the Christmas break, we did see a range of NHS leaders on television telling us that hospitals were under great pressure and the number of patients being admitted with flu was forcing them to see people in corridors and ambulances waiting on ramps. This does not surprise me, it is completely the fault of NHS leaders who have created their own crisis by refusing to commission outside services that could solve the problem and do it better and cheaper than they can.
One of the biggest problems with all this extra money going into the NHS is that it is there to prop up an organisation rather than to deliver better services and better outcomes for the population. The NHS has become an end in itself and people have forgotten that it is there to deliver the best service to citizens. We are paying an enormous price for something that is currently not working. The failure of many NHS organisations to manage the winter pressures effectively gives me little confidence they have the capacity to spend this huge amount of money wisely. The year ahead will be very challenging for social care and there is little prospect we will see much support from Government. Many providers are at a tipping point and this year may see them exit the sector, reducing services to people in desperate need and putting extra pressure on the NHS.
UK citizens should adopt Elizabeth I's motto because what we always get from successive Governments is the same broken promises, lies and half-truths. We know they will say anything to get elected and then find an excuse not to fulfil their commitments. Is it any wonder that people are disenchanted with politics and voting levels in this country are extremely low?
