The Health
& Social Care Act 2008 received Royal Assent on 22nd July 2008
but the bulk of the provisions relating to social care where not put in force
until 1st October 2010. So, in essence, there was a two year gap
between the final stage of the Parliament and the implementation of the Act. Of
course, this is just the end of the process, a bill has to travel through the parliamentary
process. For example, the controversial Health & Social Care Act 2012 had
its first reading in Parliament on 19 Jan 2011 and received Royal Assent on 27
Mar 2012, probably an extreme example but it highlights the length the process
can take.
What’s the
point of that little tour of the Parliamentary process?
Simply
speaking, the current Government has three years, at the most, left and unless
they take action soon on social care there will not be any changes to the
current system while this Government is in power, if they do, eventually,
legislate it will be left to the next Government, whoever they are, to
implement any changes made. And, more importantly, it could be close to three
years to see any substantive change in the social care system (always assuming
the Government put any substantive changes in a bill!).
To most of
us in the sector such prevarication on social care is not unusual and not just
limited to the Government in power at present. I won’t repeat the gist of my
previous blog (Politicians
Seem Clueless About Social Care) but suggest what we need is a radical
approach to reforming social care at the very top.
When Ivan
Lewis was named care minister in 2006 he promised a radical review of social care,
unfortunately that never happened and the first announcement of a consultation
on social care came only once Alan Johnson took over the role of Health
Secretary from Patricia Hewitt a year later. This suggests that any real action
on social care is decided by the senior minister who sits on the cabinet.
Obviously
the Health Minister is generally more concerned about Health Care rather than
Social Care as evidenced by this Governments pushing through the 2012 Act
despite opposition from many health professional organisations. Social Care
seems to occupy a tiny corner within the Department of Health thinking.
But why
does social care sit in the Department of Health?
Social
Care is not a minor area of public policy to be handily attached to what appears
to be the most appropriate Ministry.
The number
of people receiving local authority funded services in 2010/2011 was 1.6
million and this excludes people who pay for their own care and people deemed
by social services as not having sufficient need level to qualify for support
and who are cared for by unpaid family members etc., so true figure of those
who may need social care services is considerably higher.
Skills for
Care estimate that the social care workforce also numbers 1.6 million. So, at a
minimum, 3.2 million people are involved in social care services. Add to this
the fact that Skills for Care also “work closely with the 40,600 organisations
that offer social care people who use services, carers and with other key
stakeholders”
and
it is hard to see why social care does not get much more attention than say the
Department of Culture, Media & Sport which has a Cabinet Minister in
Charge.
It
is also important to remember that social care is not just about health,
although that may play a significant part in end of life care etc. the role of
social care is to support and care for individuals in their day to day living
and health remains the responsibility of health professionals. The public often
only connect social care with elderly care but it goes beyond this and beyond
the remit of health.
For
adults below the age of 65 who need social care services much of the focus is
on appropriate housing, employment opportunities and living independently. The
latter of which is also a focus of social care for the elderly. Social care is
about maintaining links with society and maintaining social well-being in
addition to health well-being.
We
need action on social care and we need political consensus rather than political
paralysis. Let’s start by achieving consensus that social care should not sit
in a darkened corner of the Department of Health and it deserves its own Ministry
with its own Minister who sits on the Cabinet and has the opportunity to bring
forward legislation but more importantly to show that Westminster is truly
serious about working for the millions in the country who receive or are
involved in delivering, social care services.
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