Foreword

Adult social care and support matters.

High quality social care and support helps people live the life they want to live. It helps bind our communities, it sustains our NHS and it provides essential economic value to our country.

The LGA, like its many partners in the social care sector, has worked hard to ensure that the question of how to fund social care for the long-term has had the time in the national spotlight that it deserves. But we have still not secured the action we urgently need.

The continued absence of a sustainable, long-term solution has brought care and support to breaking point. It now also means that across the country local government is struggling to sustain universal local public services like roads and waste collection as it has to prioritise statutory duties like social care for children and adults, and support for the NHS. The failure to address this creates a deeply uncertain future outlook for people who use social care services now, and the growing number of people who will need the service in the years to come.

This is a collective failure that impacts most on the very people least able to help themselves.

National governments past and present have tended to put political prospects ahead of difficult but necessary decision-making. When they have put forward proposals, national opposition parties have sought to discredit them instead of trying to find common ground. The national media has latched on to this disharmony, further fuelling the politicisation of the question of social care funding. Faced with a frustrating political stalemate, the wider social care sector at times inevitably seeks to rebuild momentum by focusing on the ‘crisis’ in care, despite knowing better than most that a more balanced narrative that emphasises the inherent value of social care is more conducive to winning hearts and minds. The preoccupation of successive governments with the state of our hospitals has impacted on the use of new money for social care.

The result is at least two decades in which the question of how to fund social care for the long-term has never enjoyed more than a few brief periods in the national spotlight. All the while, the concerns and experiences of the people who matter most – those who need care and support and their families – have struggled to get the attention they deserve. More widely, the public has largely remained detached from the debate, finding it difficult to engage with a set of questions and issues that have so many conflicting viewpoints. Most people still do not have a good sense of why social care matters, how it works and how it is funded.

Against this backdrop, the approach of governments past and present in dealing with mounting pressures in social care has been to limp along with piecemeal measures from one year to the next. Local government is widely acknowledged as the most efficient part of the public sector and councils, along with providers and third sector organisations, have responded admirably to help maximise every pound and drive innovation in the interests of people and the public purse. But with demand growing, costs rising, people’s expectations rightly increasing and funding declining, this approach of short-term sticking plasters must be abandoned. The need to resolve the long-term future of care and support is now urgent.

We cannot duck the issue any longer.

It is time to confront the hard choices, be honest about the options and make some clear decisions.

We need to come together as a society and be positive and inspiring, making the case that investment in social care and support for people who need it helps them to reach their full potential and, in turn, our nation’s.

Across the country there are many examples that show how our sector has innovated and transformed itself through world-leading initiatives such as direct payments. Positive futures for care and support, which draw on all the assets of councils, communities and civil society, can already be glimpsed and built upon.

The Government’s recent decision to delay its own green paper is disappointing and frustrating. In the context outlined above, it is also hardly surprising. More importantly, it provides an opportunity for local government – so often the pragmatic front-runner on difficult agendas and at the forefront of developing solutions to difficult issues on a cross-party basis – to seize the initiative and take the lead in forging a way ahead. That process begins here with the LGA’s green paper for adult social care and wellbeing, The lives we want to lead. It is supported by all political parties within the LGA, demonstrating the required level of cross-party support amongst local politicians that we need to see matched by our national politicians.

Much of our green paper is about the future of care and support for all adults and how we pay for it. But if our starting point is the individual person and what is important to them, then one service alone can never support them to live the life they want to lead, no matter how good it is. Our green paper therefore looks beyond social care and considers the importance of housing, public health, other council services, including those delivered by district councils, in supporting wellbeing and prevention, and the vital work with councils’ local partners, families and communities. And of course, we consider the NHS. This year we rightly celebrate the 70th birthday of our health service, but if we are to look ahead with confidence to its centenary then it too must change for the benefit of those it serves.

This is therefore a green paper for wellbeing. It seeks to lay the ground to secure both immediate and long-term funding for social care as well as make the case for a shift in approach from acute treatment to community prevention. It is about people, population and place, not structures, systems and silos. It is also just a starting point. Too often policy is developed in isolation. With this green paper we are seeking as wide a selection of viewpoints as possible, recognising that this is complex territory. There are no single or easy solutions and even within the sector there are different views on how we should move forward. Throughout this publication, we therefore pose a series of consultation questions to understand those views and identify where there is consensus or overlap. We encourage you to respond. We have also produced a separate set of tools to help gather the views of the public. Your support in promoting these would be valued as we seek to reach as wide an audience as possible on the questions at the heart of the debate.

We want to build momentum and help stimulate a truly nationwide debate about how best to fund the care we want to see in all our communities up and down the country for adults of all ages, and how our wider care and health system can be better geared towards supporting and improving people’s wellbeing. We will reflect on our consultation findings in a further publication later in the autumn, in time to influence the Government’s plans; not just their green paper, but also the Budget, the NHS Plan and the Spending Review. This is our chance to put social care and wellbeing right at the very heart of the Government’s thinking.

We have a vision for people’s wellbeing that is rooted in local areas and backed by clear and strong local democratic accountability. It is about helping to build a society where everyone receives the care they need for a good life: well, independent, at home for as long as possible and contributing to family and community life.

It is our time to drive this agenda forward.

 

Lord Porter of Spalding CBE
LGA Chairman

Cllr Nick Forbes
Labour Group Leader and LGA Senior Vice Chair

Cllr James Jamieson
Conservative Group Leader and LGA Vice Chairman

Cllr Howard Sykes MBE
Liberal Democrat Group Leader and LGA Vice Chairman

Cllr Marianne Overton MBE
Independent Group Leader and LGA Vice Chairman

What our partners have said

We’d like to thank our partners from across the sector for their thoughts, comments and input into the green paper. Here’s what they have to say…

Foreword

High quality social care and support helps people live the life they want to live. It helps bind our communities, it sustains our NHS and it provides essential economic value to our country.

Executive summary

While it is true that social care and the NHS are inextricably linked, it should be seen an essential service in its own right and the people who work hard to deliver the service should be seen as just as valuable as staff in the NHS.

Who is this green paper aimed at?

Questions about the future of adult social care and support, and the wider changes we need to make to our care and health system to improve wellbeing, should be everyone’s business.

4. The options for change

Why has it proved so hard for successive governments to deliver sustainable long term funding for this crucial service?

5. Adult social care and wider wellbeing

If we are to really tackle the full extent of future demand with quality services we need to refocus our efforts on intervening earlier and preventing needs developing in the first place.

6. Adult social care and the NHS

Joining up care and support and intervening and offering early support to keep people well is a more efficient use of resources but efficiency alone is not enough.

8. Have your say

Answer the questions relevant to you and your organisation and submit your views to be added to our research.