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Boris Johnson’s “once in a generation” plan to solve the social care crisis is faltering and well behind schedule, according to a new report by the National Audit Office.
The 10-year programme launched by the then Prime Minister promised to “fix the crisis” in 2021 but his successor, Rishi Sunak, has slashed its budget by £1.1 billion and delayed a central plank of the scheme which would see nobody having to pay more than £86,000 for residential care.
The latter would have cost £3.6 billion and should have started last month but has been postponed until 2025. The NAO is sceptical whether it will have to be postponed again with the autumn statement due later this month.
The most dramatic change has been the more than halving of the £1.74 billion promised to be spent on the programme until 2025 to £729 million.
Some £171 million is being returned to the Treasury because of the delay in introducing the charging scheme and the rest is being reallocated to other Department of Health schemes that are in trouble. This includes extra money to pay for people who cannot be discharged from hospital because of a lack of care places, more money for urgent workforce training, and more cash for care home fees.
Labour’s Dame Meg Hillier MP, chair of the House of Commons’ Public Accounts Committee, said that Department of Health and Social Care (DHSC) “still has a long way to go”.
“It has made some progress but that has largely stalled, with charging reform delayed and wider improvements scaled back,” she added. “The sector is still struggling with long waiting lists, staffing shortages and both local authorities and providers under significant financial pressure.
“DHSC needs a long-term plan to deliver its vision. It must understand if it is on track and whether its activities are actually improving people’s lives.”
The NAO found that the number of people waiting to be assessed for a care home place has risen from 395,000 to 434,000, with those facing a six-month or longer wait doubling to 82,000. There is a huge staff shortage – despite a campaign to recruit people from abroad. Vacancies have risen 166%, from 60,000 in 2021 to 152,000.
Part of the financial crisis facing social care has been the huge rise in inflation and interest rates following former Chancellor Kwasi Kwarteng’s budget that spooked the markets under then Prime Minister Liz Truss’ short-lived government. This has led to higher costs for local councils and, according to the report, slashed the profits of care home providers who then put up fees to councils and people paying privately.
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Some councils are so short of cash they fear they cannot keep their statutory duty to provide care places for the most vulnerable, including the disabled and people with mental illness.
A spokesperson for the Department of Health and Social Care said it is investing up to £700 million over this year and next to make major improvements to the adult social care system – including £42.6 million to support innovation in care and increasing the Disabled Facilities Grant by £50 million.
“Additionally, we have made up to £8.1 billion available to help local authorities tackle waiting lists, low fee rates, and workforce pressures, £570 million of which will help local authorities improve adult social care provision, in particular by boosting the workforce,” they added.