David Brindle will be joining us at Progressive Britain Conference 2024, at our panel ‘Fair Care: Can Labour deliver high quality and accessible care for all?’. Get your tickets to hear more from him there!

 

How much does Labour need to say about its plans for social care and a National Care Service before the general election? More than it is saying at the moment, certainly, but it has to stop short of giving the Tories anything with which they could fabricate a “death tax” attack line.

It’s going to be a difficult balance to strike. The social care sector is crying out for help after more than 25 years of prevarication and broken promises of reform by, it has to be said, all the main parties. I have seen this at first hand as a specialist journalist and, now, chair of a care charity that struggles day-to-day to make ends meet on the fee rates paid by local authorities and the NHS.

So far, Labour has made firm commitments only to a flagship Fair Pay Agreement for the sector and to early action to iron out the most glaring variations in the quality of care and support provided to older people and working-age adults living with disabilities. While these pledges are very welcome, detail is lacking. How, for example, is an England-wide pay deal going to be fixed and monitored in a sector of more than 18,000 employer organisations – not to mention 70,000 individuals who employ personal assistants with funding from direct payments?

Make no mistake, everyone who provides, commissions or draws on social care is united in agreement that ending the scourge of poverty pay is the immediate priority: this is a sector that employs 1.5 million workers, one in 20 of the total workforce, yet the median wage of hands-on care workers in 2023 was just £11 an hour, with one in five paid the then statutory minimum of £10.42.  After five years’ experience, the average hourly premium was all of 8p.

It shames me as an employer that we can do no better, even though we take no profit. There simply isn’t the money in the sector to do so. Labour will have to address this deficit if it is to deliver its Fair Pay Agreement – at a cost of perhaps £1bn to £1.5bn a year for every £1 boost in pay rates  – but the real challenge will come when it turns to funding the National Care Service.

The fully-fledged service, a Labour aspiration for the past 14 years, is the intended result of a decade-long programme of reform. It will not be an NHS equivalent and services will not be nationalised, but it will give people clear rights and entitlements set nationally and delivered locally via councils. Crucially, it will necessitate funding reform.

This is the third-rail issue that torpedoed Labour’s election campaign in 2010 when it was accused of planning a death tax. It then almost upset the Tories in 2017 when Labour reciprocated with accusations of a dementia tax. It now strikes such fear into both camps that neither has a current policy. Labour wants to play it long, making funding reform a second-term issue, but it is already clear that it will come under sustained pressure in the election campaign to say what it has in mind.

Shadow Health and Social Care Secretary Wes Streeting has been promising to put more flesh on the policy bones “in the not-too-distant future”. In a recent interview on BBC Radio 4 Today, he hinted heavily that this would involve an overture to other parties to find common cause, saying: “We definitely need a grown-up conversation about this.”

Will that kind of position suffice? The day following that interview, Today interviewed Sir Andrew Dilnot, architect of the 2011 social care funding reforms that have been legislated for but never implemented. Expressing doubt that there could ever be cross-party agreement – it was in his view “unlikely to work” – he argued that a new government just needed to find the courage to go ahead. It would, he said, gain enormous credit for doing so.

How Labour handles this hottest of hot potatoes in coming months could be a decisive factor in the campaign. I’m delighted to be chairing a discussion on this, and all aspects of social care policy, at the Progressive Britain Conference on 11 May. Do join me.