As Carers Week approaches, we need new thinking to protect London’s social care services against the potential impacts of Brexit. It has become a cliché to say that social care is in crisis, but that doesn’t make it untrue.
The capital’s councils are strapped for cash, driving a 48 per cent increase in the number of older people not getting the care they need. Nearly one in eight of them will struggle to live independently as the help they need to cook for themselves, to go out, or simply to get dressed just isn’t there.
Meanwhile, demand is rising, with London’s population expected to include an estimated half a million more people aged over 65 in the next 15 years. Social care for adults and vulnerable young people takes up an average of 58 per cent of council budgets. In London, that ranges from 67 per cent of total spending in Brent to 54 per cent in Islington.
Unfortunately, the government seems to be sleepwalking towards an even worse situation. Brexit chaos has already derailed plans for a social care green paper by two years. Not only has this left services dependent on annual handouts from the Chancellor, it also gets in the way of NHS planning.
Now we have another iceberg approaching. London relies on social care workers from continental Europe. In Hammersmith & Fulham, nearly a third of staff are EU or European Economic Area citizens, while in Barnet and Kingston it is one in four. Across the city, the average is 14 per cent – far higher than in other regions.
Many of these staff will want to apply for settled status. But this complicated process will thin the numbers as people struggle to get the right documents from employers. As the children’s charity Coram has revealed, the status of children of EU nationals is a ticking time-bomb that will cause further difficulties for their parents working here.
More will decide to call it a day and leave. And for new workers wanting to come to the UK, the government’s myopic £30,000 minimum salary threshold rules out almost all jobs in social care, where average wages in London are just £8.41 per hour.
All this in a system already bearing a 10 per cent vacancy rate. It simply isn’t sustainable. A new approach is needed.
In the short term, resilience is paramount. Discrete pots of money do not solve the problem, but it is clear another tranche is needed quickly to reduce the risk of care homes going bust. In tandem with this, there must be a stronger process for providers to hand back contracts to avoid the unseemly scrabble that followed the Carillion collapse.
In the longer run, the government will need to sort out the recruitment, training and conditions of social care workers so that more people find it an attractive career. Providing enough funding for councils to set a minimum acceptable standard, such as public service union Unison’s ethical care charter, would be a good first step. So would local action to set up a career path into the NHS for care workers with the right training.
The minimum salary threshold will need to change as well, as the government has already recognised for some NHS staff. The IPPR have suggested revising the shortage cccupation list to include social care, while introducing a “trusted sponsor scheme” that enables care providers who are good employers to get an increased range of visa benefits.
This is twice as hard to get to grips with while we don’t know what our future relationship with the EU will look like. But the problems faced by thousands of families in London who need care are too serious for us to forget that the engine of public policy needs to start running again.
Until then, the government is heading for a moment of reckoning in social care as the funding crisis meets an increasing inability to recruit the EU staff we need and have relied on for years.