Delay to green paper caps dismal 48 hours for social care

When Jeremy Hunt finally admitted to MPs on Monday evening that the green paper on older people’s social care would not now appear before their summer recess, as he had promised, reaction in the care sector was more weary resignation than righteous anger. Disappointment comes with the territory these days.

The much-anticipated green paper on social care for older people is due to be published in the autumn of 2018. The government originally promised the green paper before last year's general election, but then said it would be unveiled before MPs' summer recess – although there were hopes it would appear much sooner.

It was also hoped the paper would address needs across the entire adult social care sector. Instead, the paper will be limited to the government’s plans for improving care and support for older people and tackling the challenges presented by an ageing population.

There will be a "parallel work stream" on working age disabled adults, but some are concerned this report will focus on getting more disabled people into work.

The government has invited a number of people to advise on the paper, including Paul Burstow, chair of the Social Care Institute for Excellence; and Caroline Abrahams, charity director of Age UK. However, no user or care worker representatives have been invited.

During a cabinet reshuffle in early January, Jeremy Hunt became secretary of state for health and social care. Despite already having social care in his mandate, the change gave Hunt lead responsibility for the green paper.

The proposals set out in the paper will build on the additional £2bn the government has provided to meet social care needs, reduce pressures on NHS services and stabilise the social care provider market over the next three years. Once published, the paper will be subject to a full public consultation.

The news capped a particularly miserable 48 hours for social care, which had been obliged to stand awkwardly by, empty-handed, while ministers proudly unwrapped the English NHS’s 70th birthday present of an extra £20bn a year in real terms by 2023-24 in return for a new 10-year plan for the service.

Hunt, whose job title was amended in January to health and social care secretary, suggested on the BBC Today programme on Monday morning that social care’s gift was in the post. But as the day wore on, it became ever clearer that it wouldn’t be arriving until after decisions in next year’s spending review, for implementation in 2020. Postponement until the autumn of the policy green paper, already deferred since last year, simply compounded the gloom.

Announcing the further delay, Hunt said: “Whilst the long-term funding profile of the social care system will not be settled until the spending review, we will publish the social care green paper ahead of that.

“However, because we want to integrate plans for social care with the new NHS plan, it does not make sense to publish it before the NHS plan has even been drafted. So we now intend to publish the social care green paper in the autumn around the same time as the NHS plan.”

The green paper was due to set out ideas for the long-awaited reform of care and support of older people in England, following the Conservatives’ own goal on the issue at last year’s general election. In a speech in March, Hunt had spelled out seven principles that would underpin it and promised its publication “before the summer”. Civil servants had been working flat out to deliver it.

Many social care leaders put on a brave face in response to the postponement, rationalising that a later document would be more likely to contain meatier proposals than the vague ideas they had been braced for in the next couple of weeks.

Caroline Abrahams, charity director at older people’s charity Age UK and co-chair of the Care and Support Alliance, representing more than 80 care charities, said: “The need for lots more investment in social care, coupled with reform, is now so great that any delay in publication of the green paper is deeply regrettable, but frankly we’d rather have an ambitious set of proposals, with the funding to match, in the autumn than a timid paper that will not make any difference in July.

“With this delay, the onus is now firmly on the government to live up to their promises and come up with some game-changing ideas later in the year.”

Colin Angel, policy and campaigns director at the UK Homecare Association, representing domiciliary care providers, tweeted: “Probably better if it’s a stronger document, with coherent proposals for the public, but suggests that [the Department of Health and Social Care] haven’t got their ducks in a row just four weeks before intended publication.”

Paul Burstow, a Lib Dem care minister in the 2010 coalition government and a member of the government’s green paper advisory committee, tweeted: “Disappointing news. Delaying the green paper to align it with the NHS plan might make sense. But it does sound awfully like a can being kicked down the road.”

Also being delayed until the NHS plan appears is the promised joint workforce strategy for health and social care, which had similarly been due for publication in July. A draft version released last December was poorly received in the social care sector, which merited just five pages out of 140.

Pressure will now build on ministers to announce an interim funding package for social care in the autumn budget, with council social services directors warning that their provision is on the verge of collapse in some areas.

The Association of Directors of Adult Social Services wrote to ministers last week with an unprecedented offer to guarantee “line of sight” on the outcomes of any funding boost – in other words, to vouch for use of cash by its members and help avoid it being siphoned off to other council budgets. For £1bn, the association said, it could support 50,000 older and disabled people to continue living at home.