Release of social care green paper remains imminent
In the March 2017 budget, the Conservative government said it would publish a green paper on social care, for public consultation. This followed the decision in July 2015 to postpone the introduction of a cap on lifetime social care charges and a more generous means-test that had been proposed by the “Dilnot Commission” and accepted in principle by the then-coalition government.
During the subsequent 2017 general election campaign, the Conservative Party made a manifesto commitment to introduce the green paper as well as a number of pledges regarding how individuals pay for social care.
The publication of the green paper has been delayed several times; a revised time frame of before the summer parliamentary recess was then announced. In June 2018, the then-health and social care secretary announced a further delay to the autumn of 2018 following the announcement that a ten-year plan for the NHS would be developed; this was subsequently put back to “before the end of the year”.
It will now be published “at the first opportunity in 2019” according to reported comments from the government – no further details have been given as to when in 2019 publication might occur.
The repeated delays have been widely criticised by both care providers and older people’s organisations, both of which point to rising levels of unmet need as local authorities stretch their budgets ever further as demand for social care services continues to rise.
The government has said that the proposals in the green paper will “ensure that the care and support system is sustainable in the long term”. Other topics that the government has said will be included are integration with health and other services, carers, workforce and technological developments, among others.
The green paper will cover all adults – this seemed to implicitly be the case when the green paper was first announced, but during its development the government stated that it would focus on care for older people, with a separate “parallel programme” of work for working-age adults taking place (although not necessarily resulting in a green paper for this group). The position has now reverted to a single green paper for all adults.
Given that total public funding for social care for working-age adults is the same as for those adults aged over 65, it could be argued that a green paper that focused on over-65s would have been an incomplete analysis of the adult social care funding landscape.
In March 2018, Jeremy Hunt, then health and social care secretary, outlined seven key principles that would guide the government’s thinking ahead of the green paper:
• quality and safety embedded in service provision;
• whole-person, integrated care with the NHS and social care systems operating as one;
• the highest possible control given to those receiving support;
• a valued workforce;
• better practical support for families and carers;
• a sustainable funding model for social care supported by a diverse, vibrant and stable market; and
• greater security for all – for those born or developing a care need early in life and for those entering old age who do not know what their future care needs may be.
Mr Hunt added that “innovation is going to be central to all of these principles: we will not succeed unless the changes we establish embrace the changes in technology and medicine that are profoundly reshaping our world”.
The new health and social care secretary, Matt Hancock, reaffirmed the seven principles during a debate on social care in October 2018, and told the House: “those will be the principles behind the green paper, and I hope that we can build cross-party support for it”.