Social care system ‘cannot be fixed by new taxes’

The Adam Smith Institute has argued that the social care system is broken, unfit for purpose and cannot be fixed by new taxes.

The think tank’s new report claims that the whole system is in crisis, distorted by perverse incentives, unfair and woefully out of date. Amid the current coronavirus pandemic, there has been much talk about raising public care spending and providing more free care. However, the Adam Smith Institute argues that only widespread and disruptive change will solve the deeper problems and prevent future cases of neglect.

The report suggests that such ‘disruption’ to the system  could be in the form of ‘new partnerships in new markets that embrace fundamental change’. It advocates a partnership with private pension and insurance investors to develop large numbers of new and upgraded facilities, and lease them to local authorities, giving local authorities a long term, whole-service package without having to find the capital to build new homes themselves.

Most care homes with residents funded by local authorities are over 20 years old and no longer up to modern standards. Many are converted old hotels and houses, with narrow corridors, small rooms and no en-suite bathrooms. Equally, self-pay residents get a raw deal from providers and insufficient protection from regulators.

The think tank also says that live-in carers hired by families typically have no qualifications and many are paid less than the national living wage. And care delivered free to vulnerable people in their own homes by local authorities is usually selected on price, not quality, and there is very little use of modern information and artificial intelligence technology that could spectacularly raise its quality and efficiency.

Eamonn Butler, who co-authored the report, said: “People aren’t looking beyond how to get more money into social care. And more funding is seen as a magic bullet that would solve all the problems. But an arbitrary boost to care budgets will do little good. We can only solve the crisis in social care by looking at and radically reforming the whole system, not just one part of it.

“The idea of making social care free to everyone as part of the NHS, possibly funded by a new ‘care tax’, is a non-starter. The NHS has 170,000 beds in 1,300 hospitals. Adding another 480,000 beds in around 20,000 nursing and care homes would overwhelm it completely.”