Social care reform is enormously difficult and there is attraction in the apparently simple concept of mirroring the National Health Service, which could offer comprehensive, high-quality, person-centred services that meet needs and enhance lives.
What would a national care service mean?
But questions remain. Who would be eligible for publicly-funded care? Who manages and commissions it? Who provides it? How it is funded and Who would regulate it? The answers to many may not have to sit centrally and may not be best carried out at a national level.
Who gets publicly funded social care currently, unlike the NHS, depends on their assets. The levels of these are set nationally and could remain so. There is an urgent need to lower the eligibility so more people have access funded support. National rules on eligibility need to be applied evenly – unlike now where there are variations.
If eligibility should be set nationally, management and commissioning of social care should happen locally. As much control as possible needs to be in the hands of people using services. Local councils know their communities and markets, and are best placed to support a person-centred approach. Yet, possibly due to finances, they don’t always deliver.
Most of England’s 18.5k social care providers (including Deckchair Care) are in the private sector, so who delivers a national care service is more interesting. A nationalised service would be hugely expensive, legally difficult and time-consuming to implement, without necessarily delivering the benefits its proponents expect.
In many people’s view, it is better to have a mixed market of providers from the public, voluntary and private sectors. That, though, requires local authorities to pay providers a fair price for good quality care, which in turn requires national government to fund councils adequately.
In conclusion, some aspects of adult social care should be run and funded nationally. This may be more complex than some might expect of a national care service, but it will deliver better social care.
About Deckchair Care
Deckchair Care are an independent, privately-owned care agency. We look after the elderly in Cheshire and South Manchester.
Read more about our care service