Call for social care reform

by Jennifer Trueland

The BMA is calling for concerted action to ‘fix’ social care in the UK, saying that urgent steps need to be taken to improve it in the short, medium and long term.

Location: UK
Published: Monday 1 February 2021

A group of experts convened by the BMA agreed the situation isn’t sustainable, and people were being let down.

At a roundtable event, representatives of leading charities, think tanks and other organisations discussed the main challenges facing the sector and also considered possible solutions.

All agreed that the priorities for action included better funding to improve access and quality of social care, investment in the social care workforce, and a culture that valued the social care sector and recognised its importance to the wider health and care economy. They also agreed that people needed more information about their options, and said there should be better integration between social care and the NHS. 

Chaired by Helena McKeown, chair of the BMA representative body, the virtual event brought together leading voices in the field, including Andrew Dilnot CBE, currently warden of Nuffield College, Oxford, who chaired a commission into social care funding reform set up by former prime minister David Cameron.


Poor structure

Although the commission reported almost 10 years ago, its recommendations – including a ‘cap’ on the amount an individual has to pay for care and a substantial increase in the means-tested threshold above which people have to pay all their social care costs – have not been implemented, with successive governments putting off difficult decisions about the future of social care.

Sir Andrew said it was critical for the whole population that we get it right. ‘Social care is a terrible stain on our nation. It’s delivered by wonderful people to people in great need, but it’s not adequately funded and it’s not adequately structured in all sorts of other ways.’

Sir Andrew said there was an opportunity to press for change ahead of this autumn’s spending review. ‘We need to make sure somehow that we have as loud a voice as we possibly can in the middle and latter parts of this year.’

Baroness Hollins, a cross-bench peer and former president of the Royal College of Psychiatrists and the BMA, who founded a charity that provides picture books for people with learning disabilities, said social care touched younger people too.

‘It’s easy to forget that social care isn’t just about people my age and older, but people like my disabled children, and the people that my charity Beyond Words tries to support and empower and care so much about supporting people’s independence.’


Lack of resources

Caroline Abrahams, charity director of Age UK, is also one of three co-chairs of the Carers Support Alliance. ‘It’s my job to think and worry about social care and I get plenty of ammunition for doing so.

Clearly it’s probably the area of policy where we’re furthest away from where we want to be in terms of older people. Having said that, I completely agree that it isn’t just about older people – it’s about younger disabled people, people with chronic illness and it’s also about unpaid carers.’

The experts pinpointed a lack of resources as a key issue, and also a lack of consistency in how funding decisions were applied across the country. But they said workforce was also a key issue.

Oonagh Smyth, CEO of Skills for Care, said: ‘We definitely need a sustainable funding model that allows us to have the right level of support to meet unmet need, but also to have a valued workforce. Within that, it’s really clear that we need career pathways to value people who work in social care so that we get more people working in social care with the right values, but also that they stay – we’ve got real issues with wellbeing.’


Call for a strategy

She said that while there was a predicted gap in the future workforce, there was also a problem right now that had to be tackled. ‘Ultimately we do need a social care strategy but we also need to know where we’re starting, and we need a vision for where we’re ending, that starts with the needs of people accessing social care.’

The event was also attended by Ivan Camphor, chair of the BMA’s community care committee, Christine Douglass chair of BMA patient liaison group, Colin Noble, health and social care spokesman for the Local Government Association, James Bullion, president of the Association of Directors of Adult Social Services, Danny Mortimer, interim CEO of the NHS Confederation, Morgan Vine, head of policy and influencing with Independent Age, Vic Raynor, CEO of the National Care Forum, Charles Tallack, assistant director of the Health Foundation’s Health and Social Care Sustainability Centre, Simon Bottery, senior fellow with The King’s Fund, Emily Holzhausen, director of public affairs with Carers UK, and David James, head of adult social policy at the Care Quality Commission.

Dr McKeown welcomed the level of agreement between the participants and said that it would be important to continue the dialogue. 

Watch the event