Q&A – Professor Martin Green, Care England


Care England’s report card on government reform of social care


The Care Home Environment editor Tim Probert talks to Professor Martin Green OBE, chief executive of England’s largest representative body for independent providers of adult social care, Care England, about the government’s recent reform White Paper


TCHE: Out of a score between 1 and 10, how would you rate the government’s People at the Heart of Care adult social care reform White Paper?


Green: I would probably give it a six. That’s partly because at least we have a government that is prepared to announce something. But when you delve into it, the White Paper itself is very scant on detail. It’s also become apparent that the extra money being raised through the Health and Social Care Levy – for the first three years – is just going to be an NHS recovery plan rather than a proper social care one.


TCHE:So why six out of ten?


Green: There have been five Prime Ministers who have told us they are going to say something about social care reform and they’ve all failed. So they deserve some plaudits for actually announcing something.


There are some elements that we are quite


supportive of, but there are lots of challenges. The biggest challenge is that only about £5 billion of the extra money is going to come in before year three. In effect, all the money that will be raised from the Health and Social Care Levy is going to the NHS.


TCHE: Is there anything that can be done about that?


Green: The government won’t take the money from the NHS because they never do. But what might happen, and what I’m encouraging people to do, is think about what social care can do in order to get some of that money from the NHS to relieve the burden on the NHS.


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I have been talking about things like discharge to assess; and developing intermediate care so that people going to hospital for elective surgery can do their convalescence recovery in a care setting, not a hospital. That will free up a bed and free up capacity in the NHS.


TCHE: Is that something the NHS would be willing to do?


Green: I think they would be willing to do it, the stumbling block I’m having at the moment is that I want it to be done on a national level and this government is absolutely obsessed with localism. I’ve told the government very clearly that unless they come up with a national tariff and make it a national scheme, I’m not investing any time in it. I have been down this road so many times. At the start of the pandemic, we offered them new facilities - that had not been commissioned - as specialist facilities for people with Covid. That could have been developed and delivered really quickly but instead they let local authorities decide for


When the government talks about integration, they are obsessed with talking about organisation. But this misses the point. Real integration is about how you as a service user experiences the service


Martin Green


themselves. What local authorities hate is when the NHS, which pays a much more realistic fee, rains on their parade. Local authorities are only interested in the costs so when they see somebody coming along who is prepared to pay a much more realistic cost for a service – and sometimes that’s three times more than what the local authority is paying – they don’t like it.


TCHE: Is a national scheme such as this a realistic possibility?


Green: There seems to be no capacity in government to manage anything on a national level, which raises the question that if NHS England is a law unto itself and if the local authorities are calling the shots locally, what is the role of the Department of Health and Social Care and its 900 staff? I am beginning to be of the view that unless we have some clarity over what they actually do, get rid of them.


TCHE: Is there anything else missing from the White Paper that you would have liked to seen?


www.thecarehomeenvironment.com January 2022


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