You can’t have Scandinavian style health and care services on Singapore tax levels

Speaking to the well-respected Voices of Care Podcast series, several of the country’s most prominent luminaries took aim at successive governments for their continued social care failings.

Dr. Jane Townson, chief executive of the Home Care Association said to the podcasts host, Suhail Mirza: “There remain many problems to solve. And unfortunately, there appears to be little political will to do so because they <<the government>> know that the public is obsessed with the NHS. So that’s all they talk about. And I guess politically, social care has caused trouble for certain prime ministers in the past, so they are nervous about talking about it.

Her comments come in light of a Carenomics report from September 2023,  whereby it calls on the government to see the sector as an investment opportunity and not a cost. It states that the government needs to unlock the economic potential of social care’s 50 billion gross value add to the economy and the 2 million people working in the sector.

Jane goes onto say “…social care, as it stands, is about twice the size of agriculture and bigger than some other well-known sectors. So, I think maybe we’re missing a trick by not advocating it in that way…. Politically, the only way that that can be addressed is by somehow raising taxation. And that isn’t what many people want….and I think that <<we need>> an honest conversation with the British public, if you want better public services, you’ve got to pay for it. You can’t have… Scandinavian style health and care services on Singapore tax levels.”

Jane Townson was not the only guest of the podcast to point many of the sectors failings in the direction of the government with Richard Ayers, social care adviser at Care England saying: “The sector has been working collaboratively for many years, trying to influence policy and lobby both government and local authorities for more money.”

A report from the Care Provider Alliance recently pointed to a funding shortfall of over £1.5 billion for 2022/2023. But since then, inflationary pressures have likely pushed that figure north of £2billion.

Richard says: “…local authorities have underestimated the cost of care. We need to really understand what the shortfall is. The high period of inflation has, with <<rising>> energy costs, interest rates and food costs, had a very detrimental impact on the sector.”

Richard calls for a rethink and a new way of doing things: “There are only so many more efficiencies the sector can implement to try and reduce costs further and there are some marginal gains we can make. Whoever the new government is, we need a 5 year plan. We call on that government to apply zero VAT for welfare services within its first 100 days…which we estimate would put at least £350 million into the sector and the emerging ICBs can help here and look at how VAT is structured.”

The evolving pressures around ESG, social, governance and reporting are also having a significant impact on the sector. Richard states that the 68% reduction in emissions by 2030 and then 78% by 2035, the pressure to digitally transform operations is not possible within existing funding levels.

“We need more funding injected into the sector to be able to set the sector up for the future. Because we’ve got an ageing population, we need 500,000 new care workers in the next ten, 20 years. We’ve got a long, hard road ahead of us, so we need to make sure we’re looking at the future cost of care, not what it was in the past.

Richard calls on the government to professionalise the workforce, to rethink how we position it as a real career opportunity and recognise the valuable role carers provide in society, on par with the same role and value the NHS delivers and “they need to be renumerated appropriately.”

“The care sector has been ‘done to’ by local authorities, central government and the NHS for many, many years…<<the care sector>> needs a seat at the top table to help influence and direct policy in a way which is going to help recruit and retain individuals. We’ve had 70,000 people come from overseas in the last 12 months to plug our recruitment deficit. But if you think that we’ve only reduced the deficit by about 13,000, that means a shortfall of 57,000.

We’ve got a domestic workforce problem, we have to do something differently. The international workforce has saved our NHS in the past. They will absolutely no doubt help save the adult social care sector but not in isolation, not least because solely relying on an international workforce causes challenges in the countries from which they come, we can’t just steal their workforce, we must address the domestic workforce problems the sector faces.”

Stephen Pattrick, co-founder and CEO of Newcross Healthcare, one of the UK’s largest technology enabled workforce solutions provider comments: “In the Voices of Care podcast series, you’ve engaged with highly knowledgeable individuals, and the consensus in their messages has been unmistakable. As we approach an upcoming election, it is crucial to hear concrete plans from political parties, the government, and politicians regarding their strategies to address this sector’s challenges. Thus far, what we’ve predominantly encountered is a lot of empty rhetoric.”

Suhail Mirza, host of the Voices of Care Podcast, comments: “What will it take to listen to these almost perennial concerns about the state of the adult social care sector, described as ‘extremely precarious’ by Care England’s Care for our Future report published in September 2023? A humane government should be addressing this before this becomes, in the words of Professor Martin Green OBE – the CEO of Care England -who provided comments on the recent CQC State of Care report, a “total impasse.”