Thirteen years into Conservative rule, nothing in Britain works. We condemn our most vulnerable to low-quality housing, social care patients face impossibly long waiting lists, and private care costs spiral ever higher. It’s a crisis that contributes to the fate of thousands at A&E and hundreds of thousands on NHS waiting lists. When they enter government, one of Labour’s primary tests will be whether they create social care service that works.
Social care is considered something for older people, but improving access will help people of all ages and all conditions live on their terms. Most social care spending already goes to working-age adults, and close relatives and unpaid carers don’t receive the support they deserve. Instead of understanding policy as zero-sum, we should recognise that we all benefit from a society that gives us a safety net to fall on when crisis comes.
The details of Labour’s current proposals still need to be clarified. Under Corbyn, Labour had several commitments: to expand personal care, expand local capacity, improve terms for care workers, and reduce costs.
The role of the private or charitable provision, what that might look like, and how it might be funded under the new service is still under review. A proactive Labour government could use a newly empowered local government to support charitable provisions – supporting local charities would allow for more comprehensive care on a community level.
Shadow Health Secretary Wes Streeting has said the focus should be on providing better pay and terms to incentivise recruits. The emphasis here would not be on state provision but on ‘national standards’. Ultimately, the Fabian Review asked by Labour is yet to conclude, and what Labour’s plans will look like is unformed.
Good policy should address the underlying reasons for the social care crisis. The most significant is the need for spending. Despite an ageing population, national and local government spending cuts have meant we spend a similar amount on social care as we did a decade ago.
Assuming we want to return to the quality of services to the point of the last Labour government, we would need to spend at least ten billion pounds. This number, however, would need to address the significant inequalities in regional and local access to social care. The actual figure could be billions more, funding we know the Conservative government is unwilling to stump up and that local councils can’t afford. A Labour administration must prioritise increased funding for local government to address the backlog.
New treatment methods can help careers and those who benefit from social care. One of the leading causes of death in the UK is dementia, and cases are projected to rise. These longer-term conditions demand that we find solutions for those with the most acute needs, one being dementia villages.
Unlike nursing homes, dementia villages provide garden neighbourhoods designed for people with Alzheimer’s, including guard rails, controlled lighting, and a focus on ‘surface-level design’ – measures shown to reduce psychiatric symptoms measurably. Dementia patients are still given individual rooms and property but have communal spaces that let residents choose their level of socialisation based on their condition.
Treatments like this take a more holistic approach, incorporating support for care workers and families. We must find a way to reduce the need for dehumanising bureaucracies that trap patients in shortfalls. Institutions will still be at the core of our system, but we need to offer more choices for people between personal and community care.
When housing is unaffordable, that burdens a high cost for those on low incomes and who are in care. Social care patients would benefit from our councils and the government loosening our planning regime, redeveloping existing stock, and expanding investment in social housing. With more living spaces for our vulnerable, we can provide choices for those in care to live in dignity.
We need to approach the problem of supply in treatment more proactively. If we lowered the barriers to funding basic research, increased spending on medicine grants, and subsidised supply of treatments, we would be more quickly able to tackle our healthcare shortages. Take cancer – investment into research has had a demonstrable effect, enabling improved screening and new treatments, and survival rates are double what they were forty years ago. Innovative research in this area has significantly improved patients’ quality of life.
Addressing supply should come with training more doctors, nurses and care workers and offering better terms of employment. Improving staff conditions is necessary to tackle the ongoing workforce crisis. Not only will we face fewer deathly winters, but we will also be able to improve access and long-term health outcomes.
Social care is currently most spoken about during NHS winter crises, but these crises have become a year-round reality. Most political reporting begins and ends with the question of how we will pay for any reforms, but this doesn’t get to the heart of the problem: we are all paying this cost right now.
Britain is not the same country it once was; the indignity of people dying from ambulance queues. The injustice of hospital corridors overfilled with patient trolleys. The torment of pain millions endure waiting for procedures. Social care is about allowing everyone to live and die with dignity. The next Labour government will be defined by whether it affords this dignity to all our citizens.