Reactions to the adult social care green paper

Action on Elder Abuse, GMB and the National Pensioners Convention

The three organisations issued a joint response, in which they strongly backed funding the future national care service through general taxation, and attacked the government for rejecting this idea.

They said: “The organisations believe that the proposed national care services can only be properly fionanced through a universal tax-funded system, and the government’s instant dismissal of this option is not evidenced based, but politically driven. There is widespread support for this among the public and other stakeholders than the government seems to acknowledge.”

The Afiya Trust

The trust, which works to reduce race inequalities in health and social care, has raised concerns with care services minister Phil Hope about the green paper’s failure to address the needs of black and minority ethnic communities. Hope addressed a trust conference for BME carers this week at which he was questioned on the issue.

Trust chief executive Patrick Vernon said: “Phil Hope’s vision for a national care services is pointing in the right direction. However, there are still significant gaps in the green paper about how race equality will be accommodated and in recognising the current and past contribution BME communiteis have made to Britain. The equality impact assessment is very weak and doesn’t properly assess the impact of the government’s proposals on BME communities.”

British Association of Social Workers

In its response, BASW raised concerns about the “marginalisation” of social workers in adult services, saying they had been left in the position of “relaying decisions about service rationing and limited eligibility”.

Of the proposed funding options, it backed the comprehensive model, in which all pensioners would be enrolled in a compulsory state insurance scheme, which would fund care. However, it said its “true inclination” would be for funding to come from general taxation, something the government has ruled out.

It said: “We are still an affluent country and this should be possible.”

Carer Watch

Carer Watch, an online campaign group run by carers, also attacked the proposal to rule out tax-funded care, describing it as an “arbitrary decision”.

It also lambasted the proposal to use attendance allowance to finance increases to social care funding, saying the benefit was “entirely fit for purpose” as it was. The group also criticised a lack of focus on carers in the green paper.

Counsel and Care

Counsel and Care criticised the government’s failure to produce the financial modelling underpinning the green paper, saying it had limited debate on the funding options. It also said that there had been strong backing for increasing social care funding through general taxation, despite this being ruled out by the government.

Chief executive Stephen Burke said: “People are being asked to make big, long-term decisions without sufficient information and without being given the choice of funding care through taxation.”

English Community Care Association

ECCA, which represents residential care providers, backed the green paper’s clear statement that funding accommodation in care homes should be the responsibility of individuals, not the state, apart from for those with little wealth. It said this would require care home fees to be separated into care, on the one hand, and board and lodging on the other.

It said there were flaws in the government’s comprehensive model of funding care through compulsory insurance.

ECCA said: “Having paid, whether by lump sum or otherwise, each individual will want to be able to get their money’s worth. Those able to live/manage independently have no incentive to do so and the inclination will be for care and support demands to increase significantly.”

The Joseph Rowntree Foundation

Research body the JRF said a national consultation it had carried out with service users had found strong support for funding increases in social care through general taxation, despite this being ruled out by government.

It also highlighted the benefits of the comprehensive funding proposal put forward by ministers, involving compulsory insurance for older people.

However, a spokesperson added: “And while cross-party consensus appears to be emerging on the importance of change, it remains to be seen whether there is sufficient political will to bring this about. Increased and inclusive public engagement in the big care debate will also continue to be vital.”

The King’s Fund

The King’s Fund said “much work is needed on developing the aspirational content of the green paper into specific, costed and practical proposals” in areas including the new national assessment and eligibility system, with a white paper due early next year.

Its response said the government’s proposal to introduce free personal care at home for people with critical needs – made two months after the green paper’s publication – “had clouded our understanding” of the green paper options, especially as free personal care was rejected by the green paper.

In the light of this and in the absence of the financial modelling underpinning the green paper, it said it would be “premature to express a preference for any of the three funding options”.

It also said the government needed to say much more about how a future funding system would affect disabled adults of working age.

Mencap

Mencap said a consultation with people with learning disabilities it had carried out concluded that the green paper had not addressed the “future funding crisis” in services for people with a learning disability.

Chief executive Mark Goldring said: “We fully support the government’s action to improve social care but they need to act on what they are being told by the people who it is intended to support. This cannot be another listening-only exercise.”

Mind

Mind criticised the green paper’s apparent focus on older people at the expense of younger adults.

Chief executive Paul Farmer said: “Social care services are used by people of all ages with a wide range of needs, and we are concerned that the social care green paper is an older people’s paper, which is largely silent on how to meet the needs of people with mental health problems.”

Parkinson’s Disease Society

Chief executive Steve Ford said: “It’s unfortunate that positive proposals for a new care system are undermined by threats to scrap attendance allowance to help pay for it.
 
“A survey of our members of working age found that only 5% supported the replacement of attendance allowance by a national care service, with nearly two thirds (62%) stating that attendance allowance should not be abolished under any circumstances.”

Partnership Assurance (a firm providing care insurance)

Chris Horlick, managing director, care, said: “Of the three funding options set out in the green paper, we believe that the ‘partnership’ option is the best approach. It provides a safety net for the most vulnerable, while making clear that although older people with more assets will receive state aid towards a proportion of their care costs, they will need to pay privately towards the remainder.”

The partnership option is the only one of the three proposed options that does not involve the creation of a new state-backed, or state-run insurance scheme, be it compulsory or voluntary. Instead, individuals, apart from the poorest, would be left to plan how they met the bulk of their care costs themselves.

PricewaterhouseCoopers LLP

Amanda Kelly, partner and social care leader at the consultancy, said: “Although it is clear that the public are keen to be engaged on this subject, there remains a low level of awareness, and the lack of detail supporting current proposals means that the ability to engage in meaningful consultation may be compromised. We are, however, keen to see what has come out of the consultation process and are hopeful that this is the start of some meaningful debate on what is arguably one of the biggest public sector financial challenges facing the UK.”

Sense

Sense, a charity for deafblind people, criticised the green paper’s focus on personal care at the expense of other forms of support.

Sue Brown, head of campaigns and public policy, said: “Deafblind people don’t just need personal care. They need support with access to information, mobility and communication.

 “Without having their basic needs met deafblind people are effectively trapped in their own homes. This means they are unable to exercise and are isolated from their local community, which has an impact on their physical and mental health. When the green paper talks about meeting care needs, this needs to include assistance such as support workers who aid communication.”

Shaping Our Lives

Service user group Shaping Our Lives conducted a consultation with 18 service users from a range of backgrounds about the green paper proposals.

It said the great majority said social care should be funded on the same basis as the NHS – free at the point of need – and all but one said the government had been wrong to rule out tax-funded care.

There was unanimous opposition to using attendance allowance or disability living allowance to fund increases in social care funding on the basis that it would take control away from disabled people over funding required to meet the costs of disability.

Turning Point

Social care social enterprise Turning Point also raised concerns about the green paper’s emphasis on older people in its response.

Adam Penwarden, director of learning disability services for at the social enterprise, said: “We welcome many of the proposals made in this paper, in particular the focus on more integrated services and the benefits of early intervention and prevention.  However we are disappointed in how little the green paper addresses the needs of people with a learning disability and how their future care and support costs will be covered.”

Unison

Public sector union said increased funding was vital for adult social care.

Helga Pile, national office for social care, said: “Increased funding would stop the race to the bottom, that has seen home care and care home contracts sold off to the lowest bidder. This has driven down standards, as well as pay, conditions and training for social care workers. It is the elderly and vulnerable who depend on care services who suffer as a result. We know that staff are key to making sure care quality is high, so investment in them would help bring standards of care up.
 
“Unison wants to see more social care services provided by local authorities, not private companies. Local authorities are well placed to deliver the new personalised models of care, and to develop new codes of practice to go with them. If the private sector is in charge, there is a danger that people will be left with less choice, and a one size fits all model of care.”