The coronavirus pandemic has brought the social care sector into the spotlight, with some questioning whether poor management or insufficient funding have contributed to the 30,000 ‘excess’ deaths in care homes during the pandemic. A poll conducted by Redfield & Wilton Strategies in June showed that a plurality of respondents (37%) disapproved of the government’s handling of the social care sector before the pandemic, which slightly increased to 40% during the height of the crisis. This disapproval appeared on the rise; respondents in June were 15% more likely than those in April to contend that the extent of the impact of coronavirus on care homes could have been avoided.
The public is not only dissatisfied with the Government’s short-term handling of the sector, but also the current framework for social care provision in the UK. For example, half of our respondents think that social care should be free at the point of use, as the NHS is, regardless of whether individuals have contributed taxation into the system during their working lives.
Switching to this kind of arrangement would represent a significant departure from the current system, which is primarily comprised of private companies and local councils. That said, it is a system that Britain is not unfamiliar with as local councils were previously for decades the main provider of residential care for vulnerable older people. However, even though free personal care would cost £29bn more per year by 2030, such a system would broadly receive cross-party support. Indeed, our poll found that 61% of 2019 Labour voters and 43% of Conservative voters support the idea of an NHS-structure for social care, although it is likely that respondents might not have been aware of the large increases in annual spending and possible tax increases that it would require.
Another option which may address the issues in the social care sector could be funding the system like a pension, with people paying into it during their working lives and then cashing in once they retire and need social care. Overall, the pension-style option gained the support of 36% of the public. There is notably strong support (44%) among Conservative voters for funding social care in this form.
On the other hand, the option nearest to the current system—that social care should be paid for by individuals (or their families) when and if they need it, and not be provided for by the state—only garners the support of 4% of respondents. The respondents’ preferences suggest that the public is in favour of a substantial change to the social care system.
Despite its disapproval and calls for reform, the public is largely unaware of how the social care sector actually functions. Only 12% of respondents described themselves as being “significantly aware” of how social care is funded and organised in the UK.
Likewise, only 23% of respondents think it is likely that they will live in a care home at some point in their life, yet a plurality (44%) of the public ‘don’t know’. This result once again highlights that respondents might have limited awareness of how social care operates in the UK, and therefore may appear more likely to support an NHS-style system given the familiarity most respondents would have with how the NHS operates.
This lack of public understanding is further evidenced by respondents’ guesses on who the providers of social care are in their community. Local councils received the highest number of guesses at 55%, while 50% guessed private operators. Interestingly, 48% of respondents guessed the NHS even though it is a very small player in providing social care. However, in reality, while a majority of funding for social care comes from local councils and the Government, it estimated that 80% of care home beds are provided by for-profit private companies, with only 3% directly provided for by the council. These responses reveal the public’s confusion on the complex system of social care in the UK – since most funding for social care does come from local councils, many respondents might erroneously assume that social care services are therefore provided by the council when in reality it is a private contractor fulfilling the service on behalf of the council.
It is also possible that respondents were influenced by how they think the system ought to be run – namely as a state-supported system like the NHS – rather than the reality on the ground.
Overall, issues with the funding and structure of the UK’s social care system look likely to continue, especially given the UK’s ageing population. Whilst most remain broadly unaware of how social care operates at a local level, half would favour re-structuring the sector into a ‘free at the point of use’ service. The significant increase in expenditure such a system would require might not be as appealing to the public when they became aware of the tax rises it could entail. Equally, the Government may be unwilling to increase spending in social care to the level which could fund this transformation and may instead opt for a pension style scheme which has strong support among Conservative-leaning voters.
Altogether, however, the broad level of unfamiliarity with how social care is run in the UK suggests a public debate that is quite uninformed and not very advanced.