Ending the Social Care Crisis: A New Road to Reform

Channel 4 broadcast Help, a powerful two-hour drama depicting a Liverpool care home ravaged by the virus (BBC News, 2021).

At the end of the day, with sickness you just find yourself thinking what can I do? I can’t really stay out of work because if I stay out I’m just going to be paid statutory sick pay … That doesn’t pay your bills, that doesn’t pay anything. And you find yourself struggling. (Health and Social Care Committee, 2020)

Much is made of the NHS being in the top ten of the largest employers in the world, with 1.3 million people on its payroll. But social care is bigger, with 1.5 million people in England.

Much of England’s crisis in care is a crisis in workforce and stems from a failure to assess and plan workforce needs over many years.

By February 2022, the overall vacancy rate in the care sector had reached 9.5 per cent, but was much higher for care workers (11.8 per cent), registered managers (12.6 per cent) and registered nurses (17 per cent). The overall vacancy rate in London was noticeably higher, at 13 per cent (Skills for Care, 2022).

Southern and eastern European and Latin American countries rely heavily on informal and unpaid family care, with the state offering a very basic safety net through taxation or social insurance.

That we have chosen to fund social care in a completely different and less generous way than health care has unnecessarily manufactured problems at the boundary of the two services.

In Nordic countries, long-term care is part of a state-run welfare system in which services are universally available, funded largely through general taxation and highly regulated.

rooted in wider positive social and economic policy objectives.