In the face of a care crisis, only a radical plan will do: The sector is in a desperate state with dangerously low staffing levels… and it is set to deteriorate further when it becomes mandatory for staff to have two Covid jabs, writes JEREMY HUNT
Few would dispute that both the NHS and the care homes sector have faced almost unimaginable challenges in recent times – and so it pains me to say that I fear the worst is yet to come.
This week in particular will prove critical since, as the Mail revealed yesterday, health trusts across England are already reporting peak winter levels for bed occupancy long before the dreaded flu season gets into full swing. Many wards are already at 94 to 96 per cent capacity.
A great number of those beds are taken up by the nation’s elderly, many of whom no longer require immediate medical attention but who are unable to leave and live independently because their care needs have changed.
Chair of the Health and Social Care Select Committee Jeremy Hunt, pictured in September
Yet finding a place in a care home (or sending them home with a care package) is proving increasingly difficult.
The care sector is in a desperate state with dangerously low staffing levels. Unison has found that 97 per cent of care homes have staff shortages, with a third of care workers quitting their jobs every year because of stress and low pay.
This dire situation is set to deteriorate further with Thursday’s looming deadline after which it becomes mandatory for care home staff to have received two doses of the Covid vaccine.
Given the terrible impact of coronavirus on the elderly, most Daily Mail readers will think this is an eminently sensible policy – and I agree. But the short-term impact will be severe.
At the time of writing, NHS data suggests that more than 60,000 care home workers will not meet the criteria.
Many are already migrating from the care sector to the NHS, where staff are not required to be double vaccinated until April next year.
Either way, this perfect storm of circumstances could mean some care homes closing their doors by the end of the week because they do not have enough staff to operate safely. Mike Padgham, chairman of the Independent Care Group, has warned that as many as 500 homes in England may be impacted.
In the longer term, this crisis in social care – and there is no other word for it – will be compounded by the demographic time-bomb hurtling down the track.
Last year was the first in human history where there are more over-65s than under-18s globally. In the UK, the number of people aged 65 and over is growing three times faster than the number aged under 65.
This is a success story on one level, a tribute to our ever-improving healthcare. But it also has dramatic consequences for public spending.
It was Tony Blair’s Labour government which, almost two decades ago, first identified the evolving funding gap for social care. Labour also recognised that asking the state to bear the growing burden was not realistic – and that the issue required permanent solutions, not simply higher taxes.
In a country with a taxpayer-funded health system like ours, we must accept that an ageing population requires us to spend more on our health.
Healthcare now accounts for 40 per cent of our public spending and I am proud that, during my time as health secretary (2012-2018), I campaigned hard for extra NHS funding, calling for an extra health tax to help tackle the backlog in operations and recruit extra doctors and nurses.
Critical: Care for elderly has put enormous strain on NHS
It makes no difference which country you are in when it comes to healthcare spending – just as we are seeing taxes rise to meet the costs, Americans will see their insurance premiums go up, while the Dutch and Germans will see their social insurance premiums rise.
And as it happens, our taxpayer-funded system will probably cost us less because the NHS negotiates some of the cheapest drug prices in the world.
Nevertheless, I strongly believe we must resist attempting to tackle the rapidly rising costs of social care simply through more taxation or borrowing.
If we do, we risk the tax burden rising to levels that will damage the dynamic and entrepreneurial economy we depend on – not least to fund public services like the NHS. I support the 1.25 percentage point increase on national insurance and dividends announced by the Prime Minister in September to help fund social care reforms and deal with the NHS Covid backlog.
However, it can only be part of the solution. We cannot go on taxing younger working people more and more to help pay for the needs of a growing and ageing population.
What is needed is a bold and radical overhaul of the way we view our social care system, one in which we take collective responsibility for our future.
Thanks to the Mail’s tenacious campaigning, the Government has finally tackled the injustice of people being forced to sell their home to fund their care in old age and proposed a cap on care costs for an individual of £86,000 from October 2023.
But while this is welcome, the fact remains that we must all play our part in shoring up our future social care defences.
My suggestion – and it is personal to me, as other members of the health committee I am chairman of will have their own views – is that we should set up an automatic enrolment scheme for a personal social care fund, similar to the way our pension pots work. It should be phased in over the next few years to encourage people, perhaps via tax incentives, to save for future care costs they may face.
Under such a plan, as with pensions, each participant would then have their own personal account to be managed in the private sector without the dead hand of government.
Our pension system is one of our greatest post-war success stories, coupling state support with personal responsibility – the latter encouraged by tax incentives and auto-enrolment.
It’s borne out by the statistics. At the end of last year, some 88 per cent of employees were participating in the workplace scheme, the highest level of provision in the UK’s history.
And some £90billion and rising is being paid into the system each year.
Saving early and systematically for your pension is now a strong part of the British psyche – we want to be certain our housing, food and other living expenses will be covered when we’re no longer in a position to earn a living.
The Mail revealed yesterday, health trusts across England are already reporting peak winter levels for bed occupancy long before the dreaded flu season gets into full swing
So why not do the same for our care costs?
It would not be mandatory – a decent safety net should always be available for those unable to provide for themselves and if those costs were not needed they could, potentially, be passed on to their family.
But by default, people should be enrolled in a scheme that would effectively be an add-on to their pension, probably run by the same organisation.
‘Presumed consent’ is a powerful force, shown by the increase in organ donation in Wales, where a simple change requiring people to opt-out of such a scheme in 2015 has seen donation consent rates rise by a third.
Let’s do the same for social care. We need to make doing the right thing – all of us taking as much responsibility as we can for our own care – the easy thing.
Saving for yourself and your family means there is less pressure on the state.
And the harsh truth is that depending wholly on the state will be unsustainable. It will also lead to a decline in standards. Short-term help is urgently needed, especially for local authorities, to help them provide for their communities’ needs.
But ultimately, what could be more Conservative than encouraging people to make provision for themselves where they can? It is not new taxes but courage and imagination that are needed to address the needs of an ageing population – and give hope to a battered care system in desperate need.
Jeremy Hunt is the Conservative MP for South West Surrey and chairman of the health and social care committee.
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