Few would dispute that both the NHS and the care homes sector have faced almost unimaginable challenges in recent times – and so it pains me to say that I fear the worst is yet to come.
The week ahead will be crucial, because, according to the Mail, many hospitals across England have already reported peak winter bed occupancy levels long before the flu season. Many hospitals are at 94% to 96% capacity.
A great number of those beds are taken up by the nation’s elderly, many of whom no longer require immediate medical attention but who are unable to leave and live independently because their care needs have changed.
Jeremy Hunt is the Chair of The Health and Social Care Select Committee. This photo was taken in September
However, it is getting more difficult to get a room in a nursing home or for them to go home with care packages.
It is in crisis with dangerously low staffing levels. Unison found that 97% of care homes suffer from staff shortages. A third of those who work in care leave their job each year due to stress or low wages.
This dire situation is set to deteriorate further with Thursday’s looming deadline after which it becomes mandatory for care home staff to have received two doses of the Covid vaccine.
Given the terrible impact of coronavirus on the elderly, most Daily Mail readers will think this is an eminently sensible policy – and I agree. The short-term effects will however be devastating.
The NHS has not yet provided data suggesting that over 60,000 home care workers won’t meet this criteria.
Many people are moving to the NHS from the healthcare sector. Staff aren’t required to have a second vaccination until April 2019.
In either case, the perfect storm of events could see some care homes close their doors before the end of week due to insufficient staff. Mike Padgham (chairman of Independent Care Group) has indicated that up to 500 homes could be affected in England.
In the longer term, this crisis in social care – and there is no other word for it – will be compounded by the demographic time-bomb hurtling down the track.
The first year in human history that there were more people over 65 than children under 18 was last year. The UK’s 65-plus population is increasing three times faster that the under 65 population.
It is one thing that this success story is, it’s a testament to the ever-improving health care system. It also has significant consequences for the public’s spending.
It was Tony Blair’s Labour government which, almost two decades ago, first identified the evolving funding gap for social care. Labour also recognised that asking the state to bear the growing burden was not realistic – and that the issue required permanent solutions, not simply higher taxes.
A country like ours has a public health system that is funded from taxes. We have to accept the fact that we will need more money for our health as our population ages.
Now, 40% of public spending goes to healthcare. As such, I feel proud that during my term as health secretary from 2012-2018, I campaigned strongly for increased funding for the NHS, calling for an additional tax for health care, in order to reduce operational backlogs, and recruiting more nurses and doctors.
Important: The NHS has been put under immense strain by elderly care
It makes no difference which country you are in when it comes to healthcare spending – just as we are seeing taxes rise to meet the costs, Americans will see their insurance premiums go up, while the Dutch and Germans will see their social insurance premiums rise.
As it turns out, the taxpayer-funded NHS system is likely to be less expensive than the one we have now because they negotiate some of the lowest drug prices anywhere in the world.
I believe that we cannot simply borrow more money or tax to address the rising cost of social services.
If we do, we risk the tax burden rising to levels that will damage the dynamic and entrepreneurial economy we depend on – not least to fund public services like the NHS. To fund reforms in social care and to deal with the backlog of the NHS Covid, I am supportive of the Prime Minister’s September 1.25 percent increase on national insurance.
But it is only a part of the solution. It is not possible to tax younger workers in an increase of taxes that will pay for the growing needs of an ageing and growing population.
We need to make bold, radical changes in the way that we see social services and take responsibility for our collective future.
Thanks to the Mail’s tenacious campaigning, the Government has finally tackled the injustice of people being forced to sell their home to fund their care in old age and proposed a cap on care costs for an individual of £86,000 from October 2023.
While this is a good thing, it’s important that everyone plays a part in strengthening our social care defenses.
My suggestion – and it is personal to me, as other members of the health committee I am chairman of will have their own views – is that we should set up an automatic enrolment scheme for a personal social care fund, similar to the way our pension pots work. This should be gradually introduced over time to allow people to, possibly via tax incentives to, save money for any future care expenses.
Similar to pensions, every participant in such a plan would be able to set up their own account and manage it privately, without government intervention.
Our pension system is one of our greatest post-war success stories, coupling state support with personal responsibility – the latter encouraged by tax incentives and auto-enrolment.
It’s borne out by the statistics. At the end of last year, some 88 per cent of employees were participating in the workplace scheme, the highest level of provision in the UK’s history.
And some £90billion and rising is being paid into the system each year.
Saving early and systematically for your pension is now a strong part of the British psyche – we want to be certain our housing, food and other living expenses will be covered when we’re no longer in a position to earn a living.
According to The Mail, hospitals across England report peak occupancy in winter long before flu season.
Why not make the same thing for care costs?
It would not be mandatory – a decent safety net should always be available for those unable to provide for themselves and if those costs were not needed they could, potentially, be passed on to their family.
However, individuals should not be automatically enrolled in any scheme which would be, effectively, an add-on for their pension. It is likely to be run by the same organization.
‘Presumed consent’ is a powerful force, shown by the increase in organ donation in Wales, where a simple change requiring people to opt-out of such a scheme in 2015 has seen donation consent rates rise by a third.
Let’s do the same for social care. We need to make doing the right thing – all of us taking as much responsibility as we can for our own care – the easy thing.
The state is under less pressure if you save for your family members and yourself.
It is unsustainable to rely on the government entirely, it is the hard truth. This will lead to lower standards. Short-term help is urgently needed, especially for local authorities, to help them provide for their communities’ needs.
However, there is nothing more Conservative than encouraging people make their own provision where possible. It is not new taxes but courage and imagination that are needed to address the needs of an ageing population – and give hope to a battered care system in desperate need.
Jeremy Hunt, Conservative MP from South West Surrey, is also chairman of Health and Social care Committee.