Q&A


Making social care fit for the future


Professor Martin Green OBE is chief executive of Care England, the largest representative body for independent social care services in the UK. Here, in conversation with The Care Home Environment editor Tim Probert, Martin critiques the state of UK social care and suggests a better way forward


TCHE: The government said recently it is unlikely to bring forward social care reform this year as previously promised by Prime Minister Boris Johnson. Have they booted it into the long grass again?


Green: I don’t think it will come this year but the government is working on their reform package at the moment. They have got some really interesting people working on it, including Camilla Cavendish. The government has realised they have got to start reforming social care because it has been very clear during the pandemic that there is a clear interface between health and social care. Also, social care is absolutely underfunded and the government has realised that if they want a system fit for purpose, they will have to look at how it is funded. The challenge, for them, is they have got to have a conversation with the public about what people have to pay for and what the state pays for.


That is the stumbling block, and has been a stumbling block since Tony Blair asked Sir Stewart Sutherland to lead a Royal Commission on social care in 1997. We are on Prime Minister number four since Tony Blair. They have fudged the issue because they don’t want to have that conversation.


Theresa May talked about the social care challenge and, of course, that produced a minority government. They are all a bit nervous in all political parties.


have a two-bedroom flat, that probably is worth £1.5m. So, it’s an easy thing for you to pay £70,000 on care costs. There will have to be more means testing. There is means testing at the moment, of course, but the problem with that is the £23,000 savings threshold is a cliff-edge without graduation, so you spend your money until you get to that £23,000 threshold and that’s all you have left.


TCHE: What does Care England want to see in terms of government reform of social care?


Professor Martin Green OBE


TCHE: How confident are you that the government will bring forward significant proposals for social care reform?


Green: I am confident they will propose something but I’m not confident it will be necessarily radical enough. What they will probably do is tinker around the Dilnot cost cap proposals. I think what we’ll see is an element of Dilnot in the reform. One of the challenges with the Dilnot proposals is it’s a cash sum in terms of how much you pay for care, instead of a percentage of assets. In the north of England, for example, if you have a house worth £70,000 and you’ve been told to pay £70,000 towards your care costs then that wipes you out.


In central London, however, if you


We need to have skills and competencies frameworks, a training framework, a remuneration package, and a career escalator so that people know they are in a respected career


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Green: First of all, we want to see a new vision for social care. All too often the vision for social care is based on a 20th century view rather than a 21st century view. We need to shift social care from being something that works to people’s deficits and disabilities to one that supports and maximises their assets and enablement, rather than just thinking we’re going to wait until you fall down the stairs to give you support.


We need a vision that looks at an individual’s housing needs and whether, for example, they are going to be isolated. That needs to be incorporated into a vision of social care about prevention and delivering services. When we’ve got that vision, we can then look at how much it’s going to cost to deliver it in a qualitative and sustainable way. That needs to be really clear.


Another thing that needs to happen is a proper workforce strategy. We have been promised a green paper with a workforce strategy. They’ve got one in the NHS but there isn’t one in social care. Part of the workforce strategy needs to be moving social care from being a paid job to a profession. So, we need to have proper skills and competencies frameworks, a training framework,


www.thecarehomeenvironment.com • November 2020


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