When Rachel Reeves stood at the dispatch box on 30th October 2024 to provide the country with an overview of the new Government’s first Budget announcement in 14 years, I felt little optimism that Social Care would benefit to the degree everyone in the Sector acknowledges we need. However, to say that my expectations were met would be grossly understated. This budget added a further nail to a coffin that has been prepped with meticulous carpentry skills by consecutive governments for more than a generation. Having worked in Social Care for over 26 years, I can honestly say that I am continually dumbfounded by the Sector’s resilience to remain functional despite repeated efforts by policymakers in Whitehall.
The title of the Budget, Fixing the Foundations to Deliver Change, is really on point as to what is required to assist the crisis that Social Care finds itself in. Sitting with my cup of tea, in front of the TV I was reminded of sitting on the same chair on the 20th of March 2018, listening to Jeremy Hunt, the then Health Secretary, and later Chancellor of the Exchequer, when he delivered a speech with the opening gambit quoting Robert Browning: “Grow old with me! The best is yet to be”. At that time, this seemed like an opportunity for optimism, as he set the 7-point framework for what was to be the long-awaited Green Paper. This would reform the system, so that:
“Everyone – whatever their age – could be confident in our care and support system. Confident that they will have control, confident that they will have quality care, and confident that they will get the support they need”.
Lack of support in the social care sector
You don’t need to work in Social Care to have an appreciation of how the fleeting level of optimism I felt after hearing the planned Green Paper 6 and a half years ago was not long-lived. The people who require Social Care have been repeatedly let down since this time.
Lack of investment in Social Care has impacted the failure of NHS services, as people who would benefit from much more cost-effective Social Care services are consistently required to use NHS services. The way repeated governments have addressed this is to focus on increased expenditure on the NHS, whilst ignoring the poor relation that so heavily impacts it.
If the Chancellor had used the opportunity she had last Wednesday to address this issue through a significant increase in Adult Social Care, then the hope we who live and breathe Social Care once felt could have been resurrected. However, the meagre provisions promised to Social Care fall into insignificance when compared with other Sectors benefiting from the Budget:
- £22.6 billion for the NHS, with an additional £3.1 billion for capital projects.
- £11.2 billion for education
- £2.4 billion for transportation and infrastructure
- £2.3 billion for school recruitment
- £1.8 billion for childcare
- £1.4 billion to rebuild schools
Social Care has been allocated a paltry £ 0.6 billion. However, this will be divided between Adult and Children’s services.
According to the State of the Adult Social Care Sector and Workforce in England (2024) report produced by Skills for Care, social care contributes £68.1bn to the economy, employs 5% of the country’s workforce, is far larger than the NHS, but operates on a tiny fraction of its budget. Their most recent Value of Adult Social Care in England report (2021) illustrates a 175% return on investment for the taxpayer.
Why then do we find ourselves repeatedly sitting in anticipation for some good news from any government minister? Surely, this statistic, coupled with the fact that it would alleviate much-reported pressures on the NHS, would be more than enough evidence to convince the Chancellor to target investment in a more economically viable marketplace.
However, the continued lack of support from the Central Government can only lead to a more depleted sector, ergo, a less motivated, less engaged, and more stretched workforce. Find out more about the mental health challenges faced by healthcare workers here.
The core purpose of Adult Social Care is to “help people to achieve the outcomes that matter to them in their life” (The Care Act, 2014). So, in what way does this budget assist with this core purpose?
Continued financial strain for social care employees
The Chancellor continued to discuss an increase to the National Living Wage of 6.7%. Whilst I welcome such an increase as I am a huge advocate of providers being able to pay those who have a calling to care for others a fair amount, and welcomed the Department of Business and Trade’s Final Stage Impact Assessment of the Fair Pay Agreements process in the Adult Social Care Sector published only 9 days before the Chancellor’s speech, I, like many in our field find it increasingly more and more difficult to navigate a channel where we can do so. I, and many of my counterparts in the sector, would love to pay a fairer wage to the people we rely on so much, and become increasingly disheartened when valuable members of our community find they have to leave the sector to find a vocation outside the industry.
At this particular budget, this pain as an employer in the sector was heightened further as Ms Reeves continued to order Social Care Providers to pay more not only in the form of an increase in NLW and a 1.2% increase in Employers’ National Insurance Contributions, and the third knife-wielding pain was the completely unforeseen reduction of the Secondary Threshold for these payments from £9,100 to £5,000, meaning the real cost to the employer to employ an individual on a 40-hour contract will increase from £14.37 per hour to £15.79 per hour (9.9% increase). Our modelling has assessed that this increase has created an additional requirement of £2.5bn for the Adult Social Care Sector. Therefore, the £600m is, at best, a decrease of £1.9bn, even if it didn’t share this pot of money with children’s services.
The future of health and social care remains in the balance
Previous governments have failed to allow us to be, as promised, “confident in our care and support system. Confident that they will have control, confident that they will have quality care, and confident that they will get the support they need”. The new government shows little reason to have any optimism that this will change. The Government has chosen, as did its predecessors, to ignore thousands of vulnerable individuals with additional needs, to ignore 5% of the entire country’s workforce who, as a combined force, provide the economy with a 175% ROI. This budget is shameful, and once again, as a sector, it is up to us to look inwards to continue to find the strength to navigate through this quagmire.
It is up to those of us who live and work in Social Care to again find it within ourselves to look in the mirror, and convince ourselves we are doing what’s right for the people we support. Whilst nobody who finds themselves drawn to Social Care does so for financial gain, they, more than any workforce in society, are owed at least a real living wage without their employers being crippled by the government to provide it.
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