How should the social care crisis be addressed by political parties?
The adult social care crisis is growing in importance by the day. An ageing population and a lack of funding mean a robust social care manifesto is more important than ever. But how should our political parties address the social care issues in the upcoming 2019 general election - and what are their current positions on social care policy?
That is the multi-billion dollar question to which no party so far has provided a viable answer to (or, for that matter, a consistent monetary figure).
For years our governments have promised to effectively tackle the issues in the public health and social care services, but so far, none have succeeded.
From over-stretched hospitals to the closure of care homes the general election provides an ideal opportunity for political parties to radically rethink an approach to what is fast becoming a humanitarian crisis centred on the population’s quickest-growing, yet most socially vulnerable, demographic - the elderly.
Will funding fix the crisis?
With the upcoming election looming, our political parties this week shifted their focus to social care. If elected, the Conservatives have pledged to increase NHS spend to £149bn and to double spending on dementia research (amounting to an extra £83 million) a year. Labour have promised to trump that figure by a further £6bn in 2023/4, and roll out a new National Care Service to tackle the social care crisis, (including a lifetime cap of £100,000 on the costs of personal care).
This is all positive news, but it is still largely unclear just how much additional funding is actually required to adequately reinforce an over-stretched universal health and social care system that, in its current state, is failing so many.
With the government stalling delivery of its long-promised Adult Social Green Paper and the bandying about of these various figures used as a headline-grabbing opportunity to profess apparent commitment to protecting the NHS, many argue that the cash injection will do too little to address the core issues affecting a health care system heavily weakened by eight years of austerity cuts.
It’s true that additional funding will likely be limited in creating positive and sustainable impact without radical reform or structural change. For without a proper recasting of systems around recruitment, retention, capital investment, accountability, administration, accessibility and perception of value, health and social care services will continue to operate at a great loss – both on a financial and humanitarian level.
Thus, hard transparency is needed on the true estimated cost of delivering high-quality universal health care, with clarity on how it will be funded.
How can health tech help?
From our perspective, we believe the future of health tech lies in properly addressing some of the fundamental issues surrounding the care industry. How well we age is dependent on three things: the premise that prevention is better than cure; that independent living in the comfort of home is where older adults want to be for as long as possible, and that technology cannot replace carers or medics - but they can be used to radically improve the way in which they work and raise the standards of care for good.
The impact of Brexit
This becomes all the more critical to a care sector with an enormous recruitment and retention issue that will only be further affected by Brexit. Care work is high-value but severely underpaid. There are also 122,000 vacancies in the adult social care sector, and current recruitment drives are failing to attract applicants nationally. Indeed, many of the existing workforce are EU and non-EU workers and the proposed points-based system in place will likely widen rather close the talent gap required to service the care needs of an ever-growing ageing population. The implications for the care sector and on NHS hospitals is grim: we are likely to see more bed-blocking in hospitals by patients who could be cared for at home.
What should be folded into policy is a strategy that enables the social care system to quickly adopt innovation at scale in order to optimise the work of care workers and providers. We are, of course, talking about the type of health tech innovation being built around the irreplaceable, human-centred relationships which form the central tenet in the care of older adults.
Using tech to facilitate, not replicate
Instead of bolstering a waning workforce of qualified carers with bots and automation, let’s use technology to reinforce the bonds between families, communities and the state to improve the way in which we age.
Technology of this kind is being used to facilitate, not replicate, the care relationship, based on the understanding of shared responsibility. Families need more transparency around the care management, physical and mental well-being of an elderly loved one, while care providers should be made more accountable, able to log and digitise critical information that can be shared instantly with both families and other medics involved in an individual’s care instantly and in real-time. To harness technology so that individuals can, to a larger extent, take responsibility of their own health as much as possible is a compelling and empowering thing that is sure to ease the pressure of a healthcare system ill-equipped to deal with the looming ageing time bomb.
For too long, so little of the government’s budget has been apportioned to improving adult and elderly social care, with NHS hospitals being treated as the primary beneficiary of these precious health care funds. In turn, social care frequently evades inclusion in long term health care infrastructure plans. If we are to properly address the crisis in elderly care, governments must properly acknowledge care work to be as vital a profession as other posts in the medical field and must be remunerated appropriately. It can no longer be ignored.
Likewise, infrastructural change and investment needs to occur in order to make care providers tenable. The current system that sees the heavy reliance on private financiers to provide care with the objective of turning a profit for investors has proven, time and time again, to be an inadequate approach to delivering quality care. Furthermore, a report released this month showed how hundreds of millions of pounds of taxpayer’s money poured into the care home sector every year goes out to offshore investors in the form of rental fees and repayments. These loopholes must be closed, with public capital used to build an overall health infrastructure that crucially includes an empowered social care system able to cope with demand and take the pressure off hospitals.
Supporting an ageing population
To live and age healthily, safely and on one’s own terms is an absolute human right. Yet the injustice of the elderly care system sees access and quality divided unfairly between the ‘haves’ and have-nots’. More older adults than ever before are now required to pay for their care out of their own pockets, thanks to inflation in house prices that has seen cash-poor but asset-rich people with over £23,250 ineligible for free social care provision. The House of Lords Economic Affairs Committee this year posited that care should be free for all and funded from taxation. Indeed, recent polls suggest that the general public would be willing to pay more income tax to fund the health and social care services. Whether the reflection of such intent in a political party manifesto will translate to increased votes is yet to be seen.
The key takeaway
Defining a workable, saleable strategy to improve social care, particularly elderly care, is an enormous, intimidating and unenviable task, and any proposed ‘solution’ will have its fervent detractors. Yet radical infrastructural change to the care system is surely less frightening than the spiralling consequences of inertia.
Reforms need to inherently address the financial, structural and operational inefficiencies of health and social care. Perceptions of the value of elderly care likewise need to be urgently elevated to catalyse change. Inequities need to be addressed so that access to quality care becomes democratic; not just the preserve of those who can afford it. And processes need to be put in place to allow archaic systems to be innovated.
Technology is not a panacea to the complex health and social care crisis. But, by attuning technology to optimise and preserve the human-centric relationships so vital in care, innovators can impact on society on many levels: by alleviating the pressure on the NHS, enabling the care industry to optimise and thrive, and – perhaps most importantly - by giving back quality and meaning to life when these two most important freedoms start to evade us in old age.
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