When social care is discussed in the media or in Parliament, the conversation almost always focuses on the needs of older people. What is not widely known is that just over half of the adult social care budget in England is actually spent, not on older people, but on working age adults with some form of disability. And I am going to talk about both.
A lot of the discussion on social care for older people is about how it is paid for, that is to say how you split the cost between the individual and the taxpayer. That is because many older people will have accumulated significant assets by the time they need social care, and it is reasonable that the cost is shared between them and the taxpayer, the debate is about the balance between the two.
For the last two years, the Government has been talking about how to fund social care. However, the Dilnot Commission in 2011 confirmed that the public agreed that the cost of social care for older people should be shared between the individual and the tax payer.
We have already put down the foundations for some of the recommendations from Dilnot in primary legislation with the Care Act 2014. All that remains is to draft the secondary legislation to put the figure for the cap in. This could be done very quickly – taking action beats more talking.
Britain has a proud record of being a leading country on enabling disabled people to be more independent and get into work. I am familiar with this policy area because I was the Shadow Minister for Disabled People for almost three years, between 2007 and 2010, and the Minister for Disabled People between 2014 and 2015.
In our 2017 general election manifesto, we set out an ambition to get a million more disabled people into employment over ten years. That is the right direction of travel, but I would like to see us be more ambitious about both the destination and the speed with which we intend to reach it.
I have a suggestion: perhaps we should re-adopt the commitment we made in our 2015 Manifesto that ‘we will aim to halve the disability employment gap’. The Social Market Foundation has said that the 2015 commitment would see between 200,000 to 500,000 extra disabled people in work compared to our 2017 promise. In the interests of transparency, I should explain that, as the Minister for Disabled People in the run up to the 2015 election, I may have had a hand in drafting the said Manifesto commitment myself!
The Social Care Green Paper offers an opportunity to set out some of the Government’s thinking and some of the options it has for action for working age adults with some form of disability. Publishing it would kick off the necessary debate about the right solutions. The Government would have an opportunity to listen to valuable feedback from disabled people, expert organisations involved in this field and the wider public. It would then be able to set out specific actions it is going to take, legislating where necessary. The sooner we begin, the sooner we can see real change taking place and the sooner disabled people will feel the benefit.
I chair the All Party Parliamentary Group (APPG) on Learning Disability, and recently chaired a joint meeting with eight other relevant APPGs to talk about what we wanted to see in the Green Paper. This meeting was attended by a number of disabled people and campaigners for change. A summary of the meeting will shortly be sent to the Health and Social Care Secretary.
One clear theme that emerged was to see better joined-up working between the social care, health, and welfare systems. There is quite a lot of support available already, but it does not always work well together as a package. For example, if someone acquires a disability, the rest of their life (their work, their family) keeps going at the same pace but things can go wrong because the support they need, like social care, home adaptations, and financial help, do not get going quickly enough.
The funding of social care for working age adults is very different from funding social care for older people, as they often have few, if any, assets. Any kind of means testing for social care support for them runs the risk of creating further barriers to getting into work.
Looking at the system overall, there may be areas where an increase in spending is required but that may lead to savings elsewhere. For example, more resources available to enable somebody to work is likely to lead to better health outcomes as well as that person making a financial contribution to the public finances.
Conservatives want to enable disabled people to live their lives as independently as possible to reach their full potential. We should be ambitious about our commitments, so I would like to see us improve our goal for getting more disabled people into work, reverting to the better target we had in our 2015 general election manifesto. We need to see more effective joined up working between the social care, health, and welfare systems. To that end, publishing the Social Care Green Paper now would kick off the necessary debate. There are millions of disabled people in our country who will welcome us gripping this issue and making rapid progress to deliver real improvements to their lives.
And for those older people needing social care, swift implementation of a cap as recommended by the Dilnot Commission would lead to a much fairer system.