Before the general election the former government promised to ‘fundamentally change our system of care' by launching a National Care Service. With a new coalition government in power, which way now for a social care system in financial crisis?
The fierce debate over the future of adult social care has generated hundreds of headlines in 2010. Unfortunately for the learning disability community, it has also delivered few answers.
In March, the former government proposed "the biggest change to the welfare state since the creation of the NHS": the launch of a National Care Service in England. 'Building the National Care Service', the long-awaited social care white paper, promised to end the ‘cruel care lottery' and provide free care and support to all eligible adults who need it – in return for a compulsory financial contribution.
With a new coalition government now in power, it is not yet clear how closely Labour's 'route map' to social care reform will be followed. The new government has so far promised to establish a commission to advise on funding but has not fully detailed what the commission must decide on.
The former government's three-stage plan to roll out universal care by 2016 (see more details on the next page) marked the conclusion of the largest ever consultation on care and support, following on from the 2009 green paper 'Shaping the Future of Care Together'. (Mencap's consultation received over 1,200 responses alone.) However, after many months of discussion, the learning disability community remains far from satisfied.
In 2009, learning disability charities expressed concerns that the green paper did not address the extra funding needed for services for people with a learning disability. It appears little has changed. "The white paper sets out some positive principles, but the actual needs of people with a learning disability are even more absent than in the green paper," says Anthea Cox, director of the Learning Disability Coalition.
"We welcome much that is in the white paper – particularly the commitment to end the postcode lottery of care," says David Congdon, Mencap's head of campaigns and policy. "However, it is clear that the political imperative has been older people, not disabled people."
This view is shared by Cath Baker, policy and development officer for learning disabilities at The Princess Royal Trust for Carers. She argues that while the broad response to the white paper from UK care organisations was very positive, what is missing is "an acknowledgement of the life-long care pathway of people with a learning disability and their carers."
"This can be very different from care for older people," she says, "as it often means a longer and deeper involvement with the person. It is crucial to get people with a learning disability and their carers properly recognised – because the worry is that there might not be anything else for them after 'Valuing People Now' [the strategy for learning disability services for 2009-12] comes to an end."
In the introduction to 'Building the National Care Service', Gordon Brown stated its core purpose: free care for all those who need it, when they need it, wherever they live. The service promises to provide people with ‘the choice and control they demand', and to ‘realise a vision of personalised care.'
The problem is how this ‘vision' will be delivered and paid for. "The precise details remain unclear," said Su Sayer, chief executive of United Response. "The white paper promises that a cross-party commission will work out the details in the next parliament. However, we know that the funding of social care is facing serious difficulties."
The election manifestos of all three main parties failed to answer the funding conundrum in any real detail. The Liberal Democrats backed Labour's idea of a cross-party commission to look at funding. And the Conservatives, who labelled Labour's option of a compulsory insurance scheme a ‘death tax', gave no further detail on their plan to ask people for an £8,000 voluntary contribution when they retire.