Paul Burstow writes: Greater focus on funding, prevention and integration essential to improve the social care in England

The law governing social care in England is a dog’s breakfast. The product of 60 years of piecemeal legislating it is complex, confusing and sometime contradictory patchwork that is out of date and hard to understand. The government have recognised the need to change this and last year published the draft Care and Support Bill, Caring for our future: reforming care and support, to overhaul the legal framework.

As the Minister at the time I led drafting the Bill drawing on the recommendations of a Law Commission Review.  My aim throughout has been to secure a modern legal framework that is fit for purpose, to make the Bill the best it can be.  That is why the Bill was published in draft and why I was keen for a Committee of MPs and Peers to examine it thoroughly.

It was in that spirit last November that I found myself being asked to chair a cross-party Joint Committee of MPs and Peers responsible for scrutinising the draft Bill.  We publish our final report and recommendations today.

The Committee in a unanimous report agree that there is much in the government’s draft Bill to welcome. But we are clear there is still room for improvement to ensure reforms set out in the Care and Support White Paper are realised. We need care and support to be more focused on preventing and postponing the need for care and for it to be more joined up with housing and health.

Our report also warns that the government has not fully thought through many of the implications of its social care reforms, some of which may leave local authorities open to a deluge of disputes and legal challenges, for example, coping with the 450,000 people already paying for their care who will want to register for the Dilnot cap.

Without greater integration, particularly with health and housing, the care and support system will be unsustainable. There is a growing imperative to join-up services so they fit around people’s lives and make the best use of resources. The whole system must shift its emphasis away from crises and towards prevention and early intervention. The draft Bill as it stands goes part way to addressing this, but we believe it could do more.

As awareness is a key part to this, our report calls for a nationwide campaign to educate people about the need to pay for their own care, as evidence suggests that adult care and support are poorly understood. Ignorance of how the system works is in itself an obstacle to people taking steps to plan, prepare and avoid potential future care needs.

While reforming the law governing adult social care is a key piece of the puzzle, so too is addressing the future of care funding – an issue I explore further in a publication with the think tank Localis. Almost every witness told us the system was under mounting pressure, with demand rising and resources not keeping pace.  The government must take proper stock of its funding for adult care and support and think seriously about whether the transformation we all want to see can truly be delivered without greater resources.

Much to the Coalition’s credit, after years of successive governments kicking the can down the road, the recent announcement of a cap on care costs was hugely encouraging. While the cap itself is higher than many would wish, the protection from catastrophic costs it signifies may be the key to installing prevention across the board, because it will help people to plan and prepare. Pre-budget day noises from the Treasury suggest that on Wednesday we may be nearer to the implementation of a slightly more generous cap. Either way this is a big win for Nick Clegg who went into bat for the policy against Treasury opposition.

But, even with the cap on costs and the protection that it will offer, there is more to do if social care is to be moved from the critical list. A capped cost system tied to an eligibility threshold likely to be set at substantial will do nothing to address the ongoing challenge of funding in the social care system as a whole. The wider the gap in social care funding grows the more it will destabilise a fragile system, and jeopardise the vision of the government’s social care reforms.

Measuring the size of the gap and fixing it is something we simply cannot afford to delay any longer.  After all, it seems a strange logic to put off the steps needed to create a sustainable and effective social care system when an unreformed one will simply shunt increased costs onto the NHS. This approach can only lead to a crisis in already squeezed heath budgets, and inevitable demands for increased health funding to cope.

* Paul Burstow is Liberal Democrat candidate for Sutton and Cheam and was the MP until the dissolution of Parliament on 30th March.

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