Transforming social care and healthcare in the UK

The social care system in the UK is an absolute disgrace. At the time of writing, the most vulnerable people in society are being forced to sell their homes in order to fund their care, which is fundamentally wrong. When people have worked hard and paid their taxes it is reasonable for them to expect that the state will look after them in their old age, without demanding that they sell their own home to fund it. Unpaid carers are the backbone of the social care system and without them the government would simply be unable to run its social care system at all. Therefore, it is vital that the government transform the social care system into one that gives old people dignity without stripping them of their assets and supports unpaid carers who do the lion’s share of the caring work.

Social care:

Providing free personal care:

The government should provide free personal care to all elderly people who require social care. This is because at the moment the elderly and disabled, who are often on a low income, are having to pay for carers to come in and help them with personal care tasks. It is clear that this is wrong. The elderly and the disabled are some of the most vulnerable people in society and asking them to endure financial hardship in order to pay for the care that gives them their dignity is immoral. We should view providing personal care to those who are elderly and disabled as a moral imperative. This is because ensuring that the sickest and most vulnerable people are able to wash, dress and eat hot food every day is the most basic requirement of a decent society. The government should legislate to make all personal care in England free, as the government in Scotland did several years ago. Devoting a portion of our council budgets to funding free personal care for the disabled and the elderly will be good value for money. This is because it will help keep people in their own homes for longer, which will reduce the costs that the government and the council incur by taking these people into care homes.

Care homes:

The government needs to reform the way that care homes are funded. This is because at the time of writing, too much of the burden of paying for care lies on care home residents and their families. This is clearly wrong. Care homes are often charging exorbitant fees and are sometimes exploiting the most vulnerable people by charging excessive fees for care. This is having the effect of depriving families of inheritances as people are being forced to sell their homes to serve these exorbitant fees. Clearly, this is unsustainable as many families are holding off putting elderly relatives in care homes until the last possible moment because they are worried about being able to pay the care fees. The government needs to reform the way care homes are funded and how people are charged for care fees. The social care cap that was proposed by the last government and has been ditched by the current government would have been a vital step in the right direction. This is because it would have capped the amount that individuals and families would pay for care, thereby curbing the excessive care fees that care providers currently charge. As the Labour government is not going ahead with the social care cap, it must now find other ways of reforming the way social care is funding.

The government could start by reforming how they fund local councils as many councils are facing bankruptcy, in part because of the burgeoning costs of adult social care. There is an argument for government to fund adult social care centrally as everyone in the country is going to need social care at some point in their lives, regardless of where they live in the country. This means that there needs to be long-term planning with regards to how adult social care is going to be provided and funded. Given the current state of local government finances and the difficulties councils find themselves in, it is likely that only the government will be able to establish long-term funding for adult social care. Therefore, there is a powerful argument that the government should fund social care directly as failure to address the funding issue only means that more families will struggle to meet exorbitant and sometimes exploitative care home costs.

Hospices:

The government should increase funding for hospices. This is because hospices are charities that rely on charitable donations to be able to provide the essential services that they dying rely on. Providing some government funding to hospices will provide certainty to the people who rely on them and allow them to provide more care and support to those who are dying. Increasing government funding for hospices will provide more certainty for them as organisations. In the current climate, hospices are struggling to meet their essential running costs and are finding it difficult to provide the full spectrum of support that dying people need. Reducing their reliance on fundraising by having increased access to government funding will allow them to provide a more consistent and stable service to patients and their families. This means the government should seriously think about making funding available to hospices in order to support their vital work with those who are dying.

Supporting unpaid carers:

The government should introduce measures to support unpaid carers. This is because unpaid carers are the engine of social care in this country, given the industry shortage of care staff. The last Conversative government introduced a week’s unpaid carer’s leave for employees and workers who needed to take time off to look after relatives that they care for. However, this is not enough. One way that the government could support carers is by increasing the paid holiday entitlement from four weeks to six seeks. This would allow employees to take more paid holiday which could ease the pressure on unpaid carers as they would be able to take more time off to care for relatives and would be able to do this without losing their income.

Alternatively, the government could increase the amount of unpaid carer’s leave those employees can take. Increasing the number of days an employee can use as unpaid carer’s leave from a week to two weeks would help employees manage the needs of caring for relatives while ensuring that they can continue to work. This is because employees often need extra leave, above and beyond the time off for dependents that already exists. Therefore, it is clear that making the paid holiday entitlement more generous and making the unpaid carer’s leave more generous would support unpaid carers by ensuring that they can access sufficient leave time to enable them to care for dependent relatives while allowing them to continue working in paid employment.

Carer’s Allowance:

Carer’s Allowance needs to be reformed so that it truly supports carers. This is because at the current time of writing the government is prosecuting carers for benefit fraud when most have made innocent mistakes. Claimants of Carer’s Allowance are often some of the poorest people in Britain who give up work to care for relatives who would otherwise be dependent on the state for care and support. The government should reform Carer’s Allowance so that it is more supportive of those who claim it. The government should reduce the number of hours claimants are required to care for a relative for. This is because most claimants of Carer’s Allowance have to take up paid employment to boost their household income. Reducing the number of hours carers have to spend providing unpaid care to receive Carer’s Allowance would help reduce poverty. This is because carers would be able to work more hours and therefore increase their monthly income from employment.

Furthermore, the government should increase the income threshold which is the maximum amount you can earn from paid employment before you lose your entitlement to Carer’s Allowance. Given that most unpaid carers devote most of their time to caring for loved ones, they are usually only able to work part-time. This means that they are limited in how many hours they can work and how much they can earn, which often makes it that much harder for them to afford essentials. The current income threshold is £151 a week, which is nowhere near enough to allow carers to take up decent employment which allows them to earn a good wage. The government should at least double the current income threshold as this would allow claimants to be able to earn more money from paid employment without worrying about losing their eligibility to claim Carer’s Allowance. Increasing the income threshold would also be of benefit to the public purse. This is because allowing unpaid carers to earn more from paid employment will reduce their dependence on welfare benefits as they will be able to afford more of the essentials themselves.

The NHS:

The National Health Service is one of the most beloved institutions in Britain. However, given the rising waiting lists and the problems accessing healthcare, reform is greatly needed to ensure it survives the current economic turmoil.

Social care:

We urgently need to see the social care sector reformed. This is because there are a lot of hospital beds in NHS hospitals that are being taken by elderly and disabled patients who could be discharged back into the community but are still in hospital. The reason they are still in hospital is because there is either no social care available in the community or there are no places in nursing homes available. This is clearly unsustainable as those hospital beds are needed for patients who are seriously ill or injured. Having patients who are medically well enough to be discharged still in hospital simply because there is no care for them in the community is unacceptable. Therefore, the government needs to reform the social care sector to ensure that social care is available in the community and there are more places in care homes to ensure the timely discharge of medically fit patients who would otherwise still be in hospital.

Primary care in the community:

The second thing we need is better primary care in the community. This is because there has been a rise in people being unable to work due to ill-health and people going to hospital because they can’t access care in the community. The government needs to create more GP appointments and increase access to community pharmacists in order to reduce the pressure on accident and emergency departments at hospitals. Furthermore, making it easier for people to access GPs, dieticians, physiotherapists, occupational therapists, and pharmacists will improve people’s health and reduce their absence from work due to sickness. This is because having easier access to community healthcare will make it less likely that people will need to go off sick while they wait for healthcare. This will reduce the number of people claiming sickness benefits and will reduce the welfare bill the government pays out while also reducing the number of people out of work. Therefore, the government should be moving to expand the services offered at GP surgeries, put more health professions in the community, and ensure that people have more access to community healthcare.

Dental care:

The third thing we need is more dentists and more dentist appointments. In a recent Panorama TV programme, we saw that one of the leading causes of children having to go to hospital is tooth decay. It was explained that the lack of access to dentists and dentist appointments is a significant problem for many people. The government should consider approaching all private dentists in the UK and offering them each an NHS dentistry contract. Approaching existing dentists with offers of NHS contracts would be a quick and effective way of creating more dental appointments within the NHS system. This would act as a buffer while we wait for student dentists to qualify and take up positions as dentists within the NHS. Asking private dentists to take on NHS contracts can only be beneficial as it will ease pressure on NHS waiting lists and ensure that more people have access to dental care. Therefore, the government needs to move quickly to build a positive relationship with private dentists so that they can create more dentist appointments so that fewer people are suffering from poor health while waiting to see a dentist.

Mental health care:

The fourth thing we need is better, more compassionate mental health care. Several TV exposés have shown serious abuse and mistreatment taking place in mental health units. In one documentary, the abuse and frankly sadistic treatment that autistic people were subjected to was abhorrent. It is clear that the government needs to radically reform mental health care in this country. We need to see the Mental Health Act overhauled so that it specifically outlaws abuse and mistreatment and we need to see the mental health units subjected to more rigorous and regular inspections by the regulatory bodies. Instituting these reforms will help safeguard vulnerable patients in mental health units as forcing more transparency on these units will help uncover and detect instances of abuse. We also need to see more mental health nurses in police stations and GP surgeries as well as increased access to mental health care in the community. Therefore, the government needs to conduct a root and branch overhaul of mental health care in this country to make mental health units safer and to ensure that everyone has access to compassionate mental health care both in hospital and in the community.

Neurodivergence:

The fifth thing we need is faster and more effective diagnoses of neurodivergence. From the recent Panorama TV programme, it is clear that children are having to wait many years for diagnoses for autism and ADHD. This is clearly unacceptable. Improving the life chances of children and ensuring that every child gets a good education requires children with neurodivergent conditions to be diagnosed swiftly. Getting a swift diagnosis is vital to ensuring children can access support and special needs provision in schools. Furthermore, we need increased access to counselling, school nurses and specialist therapists to support neurodivergent children in schools. This is because children with special needs require specialised support in schools in order to thrive. Additionally, we also need greater special needs provision in education. This means that we need more special needs schools and more special needs units within mainstream schools. This is because sometimes children with special needs do not thrive in mainstream school and those children require specialist services and support. Therefore, the government needs to make significant investment in the Child and Adolescent Mental Health Services and reform the education system to ensure that children can access swift diagnoses and specialist support.

Overall, it is clear that for the social care system and the NHS to survive, urgent reforms are required. We face an urgent crisis in social care with many families struggling to raise funds for care home fees and care home residents forced to sell the family home to pay exorbitant fees. With hospices facing a funding crisis, the reliance on unpaid carers, the unsupportive nature of Carer’s Allowance, the shortage of NHS dentists and the failing mental health care services in the UK, it is clear that the government must act without delay. The government should make a sizeable investment in introducing reforms now and change the way social care is funded so that the health and social care system that we all rely on, and will all need at some point in our lives, is fit for the future.

Written by Nisha Rikhi