08 Sep 2021

Political Insider: Social Care Reforms

Following yesterday’s news on social care reform, MHP Mischief’s Public Affairs team explore the key announcements, with analysis from MHP Mischief Senior Adviser and former Health Minister Paul Burstow


“We will fix the crisis in social care once and for all with a clear plan we have prepared.”

So said Boris Johnson on the steps of Downing St in July 2019 immediately following his appointment as Prime Minister.

Two years and one pandemic later, we now finally have sight of that plan and, critically, how it is going to be paid for.

We also see laid bare in front of us the massive impact the Covid-19 crisis has had on the NHS capacity, or lack thereof, to treat millions of people across the country currently awaiting much needed treatment.

We look at what exactly the Prime Minister’s announced yesterday afternoon on reform to the social care sector and to tackle the NHS backlog in England.

Alongside looking at the specific proposals set out, we also hear from Engine MHP Senior Adviser and former Health Minister Paul Burstow who analyses what this means for both the health and social care systems and how Westminster has reacted to the announcement.

What did the Prime Minister announce?

Key announcements:

Social Care

  • People will no longer pay any more than £86,000 in care costs over their lifetime, from October 2023
  • Those with less than £20,000 in assets will have their care fully paid for
  • There will be help for people owning between £20,000 and £100,000 in assets
  • The amount of help given will be based on a means test, with the details of how this will work to be announced at a later date

NHS catch up

  • With 5.5 million people in England currently waiting for treatment on the NHS, the Government will spend £2 billion this year, double its previous commitment, to start to tackle the backlog
  • In addition, the Government plans to spend more than £8 billion in the following three years from 2022-23 to 2024-25
  • The funding being put in now could deliver the equivalent of around nine million more checks, scans and procedures
  • It will also mean the NHS in England can aim to deliver around 30% more elective activity by 2024-25 than it was before the pandemic
  • Once the NHS has recovered from the pandemic, activity should be the equivalent of 10% higher than under the NHS Long Term Plan
  • The Government will also establish a new £250 million Elective Recovery Technology Fund to enable cutting edge technologies and provide £250 million in funding to increase operating theatre capacity and improve productivity in hospitals, which together will increase elective capacity

Tax rises

  • National Insurance (NI) will rise by 1.25% from next April
  • From April 2023, this extra payment will become a separate tax – called the Health and Social Care Levy – on earned income. It will show up separately on payslips
  • The levy – unlike NI – will also be paid by people who continue to work beyond retirement age
  • The government says the changes will cost £255 a year for someone earning £30,000, and £505 a year for someone on £50,000
  • Shareholders will also have to pay 1.25% more in tax on the profits they make
  • The changes are expected to raise £12bn a year
  • The government says that, for three years, all the money will go towards easing the NHS backlog, before more of it is moved into social care

Political Analysis

Paul Burstow


MHP Mischief Senior Adviser and former Social Care Minister

The social care ‘plans’ outlined by the PM today kick the can down the road once again. Extra funding will be directed towards the NHS while social care is left in a precarious state. The decision to introduce in 2023 a cap on care costs along with a more generous capital floor were both recommended in the Dilnot Report in 2011. Welcome though they are they do not add up to the comprehensive reform that is needed. The legislation is already in place so why the delay?

In recent years demand for social care has risen dramatically whilst access is increasingly rationed. This is not just about an ageing population, over half of local council social care spending goes on supporting working age people, especially those with learning disabilities.

The PM said that you can’t fix the NHS without fixing social care. True. But today’s announcement fails that test, it does not fix social care. The majority of the monies raised will go to the NHS and yet underinvesting in social care, especially the types of help that keep people independent and in the community simply stores up costs for the NHS.

Pooling the risk of catastrophic care costs – the cap – does not inject a single extra penny into the day to day budgets of social care services. The PM has promised an extra £5.4 billion over the next three year for social care, but this falls far short of all the independent assessments of the funding gap.

There is an urgent need for a long term plan for social care which increases access and improves the quality and peoples experience of care. That means addressing the sector’s chronic workforce pressures which have seen staff turnover rates over 30%.

Social care yet again finds itself the bridesmaid but never the bride. A promise of reform in three years time. But a failure to grasp the once in a generation opportunity to deliver real change in the quality of life of millions of our fellow citizens who don’t have a house to sell to pay for their care.

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