Interview: Professor Martin Green
‘They think about the NHS, and social care is an afterthought’
The Care Home Environment editor Matt Seex talks to Professor Martin Green OBE, chief executive of Care England, about social care funding and reform, and the ongoing fallout from the pandemic
The Care Home Environment spoke with Professor Martin Green in August, with the Conservative leadership contest in full swing, with the future of the much-mooted Health and Social Care Levy in doubt, and as numerous voices from the social care sector continued to express their frustration at the government’s failure to implement and finance reform.
TCHE: In light of what the candidates for the Tory leadership have said, are you even remotely optimistic about the future of social care funding and reform at this point? MG: If Liz Truss wins and she takes away the levy, then there is going to be a big gap in the funding, and then the reform agenda will probably be pushed back because I don’t see where they will get the money from to do that. And if Sunak wins then I think it will be business as usual for the reform agenda, but the problem with the reform agenda is there is not enough money in it to do what the government wants to do.
TCHE: Even with the Health and Social Care Levy, there wasn’t enough money. MG: The issue about the levy which was so annoying to me was that it would have raised £39 billion and they promptly gave £35 billion to the NHS, which had already received huge amounts of extra money. If they had said: ‘we will give £10 billion to social care’, that would have been transformational, but they didn’t do that. What they did was what they always do – they think about the NHS, and social care is an afterthought.
TCHE: It does seem that way. We’ve gone from not enough to potentially nothing at all. MG: Exactly, because if Liz Truss takes away the levy, then she’s either got to find £39
September 2022
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billion from somewhere else or she’s got to think about whether or not this reform agenda can go ahead.
TCHE: How long can the system as it currently stands still function? What happens if things just carry on the way they are?
I think there’s very little time left, and what we’ll see, if things carry on the way they are, the impact will be felt in the NHS. So already, you’re seeing huge waiting lists in the NHS, you’re seeing people who can’t be discharged to care homes – often that’s because the care homes haven’t got the money to be able to recruit staff. We’ve got a real crisis in staff
recruitment and retention. Now, we could solve that problem if we had, first of all, the money available to give people a proper reward for the fantastic work they do. And also if the government would come up with a workforce strategy that would position this as a career rather than a job. What they do is they constantly throw
money at the NHS. The NHS spends a hundred thousand pounds a minute on training. Then social care is thrown a few scraps. They did a workforce strategy in the health service but did nothing in social care, and yet they stand behind lecterns and talk endlessly about integration. Well, if integration is going to be real, it’s going to have to be seen in pay, conditions, training – a whole raft of areas. At the moment they
I want an integrated approach to planning for a pandemic, and that would be something tangible that came out of a public inquiry
have two parallel universes – one of which is kept in abject poverty, and the other is given lots of money.
TCHE: So potentially we could see people piling up in hospitals because they’ve got nowhere else to go? MG: Definitely. We’re seeing it now. There are serious strains in the hospital system at the moment with people who can’t be discharged, but there never seems to be any concerted action from the government. I said to the government before the pandemic: what you need to do is you need to have a reablement and discharge tariff from the NHS that goes directly to the care provider, cutting out the local authority. But of course the moment you suggest that, and you know that it will be realistically funded, the local authority goes into absolute panic, because what will happen is the NHS will pay about £1,200-1,500 a week and in some areas the local authority will be paying £400 a week.
TCHE: At what point will the crisis in social care become so visible and so acute that somebody will have to do something? MG: The problem will be that the impact will be felt in the NHS, and the default position of the government, the media, and
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