Learning Disability Today
Supporting professionals working in learning disability and autism services

What will the new health and social care reforms mean for people with a learning disability?

The Government has announced a £12 billion per year package of health and social care reform that many have called a ‘positive step forward’ but one that is unlikely to ‘fix’ social care or tackle the NHS pandemic backlog.

Reforms will be funded through a new manifesto-breaking 1.25% percentage point rise in National Insurance from next April. This health and social care levy moves the UK tax burden to its highest-ever sustained level, according to the Institute for Fiscal Studies. 

The majority of money raised over the next three years will go to the NHS to help it recover from the pandemic and the care backlog that has built up with more funding promised to social care after that.

The Government calls it the biggest catchup programme in the NHS’s history. It says the new funding could deliver the equivalent of around nine million more checks, scans and procedures. 

Yet, many organisations and charities working with people with a learning disability have said that the social care sector can not afford to wait for the NHS catchup programme to complete as social care is in crisis now. 

There are also fears that an ever-growing NHS budget could swallow up all of tax rise, leaving little for social care in the future.

Social care cannot wait three years for funding

Other key proposals include no one having to pay more than £86,000 in care costs from October 2023 – not including food and accommodation – over their lifetime.

Once people have reached this cap, ongoing costs for personal care will be paid for by local authorities. Those with between £20,000 and £100,000 in assets will get means-tested help towards costs from their local council. Those with less than £20,000 will not have to pay towards care costs from their assets at all, but might have to contribute from their income.

The Health Foundation says although the social care cap is a bold step forward, the proposals do little to help the third of care users aged under 65 years who rely on the quality of the publicly funded system. Further decisions on wider funding and reform will now have to wait forthcoming autumn spending review.

It also added that although a huge amount of money had been promised to the NHS, the scale of the care backlog would have required closer to £17 billion over this parliament. Money is also far from the only challenge. The extra staff, beds and equipment needed to treat so many more patients in the coming years are likely to be the biggest hurdles to recovery. 

At a press conference, Health Secretary Sajid Javid admitted that it may take longer than three years to clear the backlog for NHS operations meaning social care could have an  even longer wait for funding.

Millions of disabled people and family carers have been left behind

Mark Adams, CEO of Community Integrated Care, said the Government had failed to recognise the millions of family carers, disabled people and social care workers who have been left behind.

He added that the solution doesn’t ‘fix social care’ but instead tidies the tip of the iceberg. And despite the rhetoric, the Government is no closer to fixing the generational crisis that is engulfing social care.

“Whilst reducing the cost of care for older people is vital, they represent only part of the community that social care serves,” he said. “The government has focussed on the recognisable, understood and politically positive aspects of the social care crisis. 

“We are facing a systemic crisis. The sector loses 34% of its workforce every year. Frontline care workers are frequently paid £7000 less than their counterparts in other public funded sectors. Half a million people have left employment in the past two years to become family carers. Hundreds of thousands of people miss out on vital support every year. Put simply, social care sector needs bold leadership and vision from government and we implore the Prime Minister to deliver further progressive reform.”

What will the new reforms mean for people with a learning disability?

Mencap say that although it welcomes the changes, they don’t address the short-term funding crisis and it can’t see how the proposed cap on care costs will benefit people with a learning disability.  

Edel Harris, Chief Executive, said: “The announcement won’t be enough to fix the crisis that is happening right now. People who need care are missing out, others are having their support cut and some are being asked to pay towards their care which they simply can’t afford.

“Every day, carers are leaving the profession because they don’t get paid enough for the skilled work they do. We’ve seen nothing to reassure us that hard-working care workers will get a much-deserved pay rise, even though providers like ourselves are losing staff to become delivery drivers and supermarket workers. The risks to people and their families in need of care is real if carers continue to leave the sector at the current rate.”

Learning disability charity Hft also said it was concerned the new funding will not sufficiently meet the needs of both the NHS and the learning disability sector.

CEO Kirsty Matthews said: “We are keen to understand how the government plans to place social care on a sustainable footing. A funding solution must ensure providers no longer have to resort to handing back contracts, offering care to fewer people or making staff redundancies to mitigate cost pressures as illustrated by Hft’s Sector Pulse Check report.

“Any plans for social care reform must also address the multitude of other systematic issues in the sector such as high rates of staff attrition and low pay. The upcoming consultation on social care reform will therefore provide a vital opportunity for the needs of those who draw upon, and work within, social care to be expressed and addressed.”

The National Autistic Society added that autistic people and families have long been calling for a significant increase in social care funding and the announcement was a once-in-a-generation opportunity to fix the system, but it was worried about waiting three years to see all of the funding for social care in place.

Tim Nicholls, Head of Policy, said: “Our research suggests that two in three autistic adults don’t get the support they need, for instance to do things like wash, manage money or get out of the house. We continue to hear awful stories of people becoming isolated, developing mental health problems and finding themselves in crisis. The pandemic has only made things worse.

“We urge the Chancellor to invest what’s needed now in social care, provide local councils with the funding they need and properly fund the autism strategy beyond the next year. Autistic people can’t wait any longer.” 

A vote on the tax rise will take place later today.


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