From the National Assistance Act to a National Care Service?

Celebrating and valuing social care

Most of us, at some point in our lives, will need to draw on social care and support for ourselves or for our loved ones. It is a service for all of us, which had its beginnings in the 1948 National Assistance Act as the NHS was formed and which we are rightly celebrating this week. But shouldn’t we also be celebrating social care services and using this moment to push ahead with the investment and changes that are needed in social care?

But while social care is a sector of national importance, its crucial role is often under-appreciated, as demonstrated by the failure of successive governments in Wales and the UK to deliver the reform that is needed to ensure social care services are adequately funded and staffed and available to all of us that need them.

For too many of us, navigating the social care system is complex and difficult. It can be difficult to know what our rights are, what we should be entitled to for ourselves or our loved ones, and what we will need to pay. Waits for assessments and care to be arranged; being stuck in hospital despite being medically fit due to a lack of care workers in their area; or being unable to find a place in a care home close to family and friends, are all common experiences. It’s not surprising that anxiety about social care services amongst older people is high – in a recent survey of older people in Wales, 76% felt anxious about the state of social care.

Difficulties accessing social care also impact more widely, with loved ones needing to take on caring responsibilities, for example, to ensure someone receives the care and support they need, something we know impacts upon many aspects of people’s lives.

While funding and resources are obviously crucial elements in terms of tackling these kinds of issues, other action is also needed to raise the status of social care, which would help to deal with wider issues such as staff recruitment and retention.

We need to see parity between pay and conditions for comparable jobs in the NHS and in social care. We also need to recognise that providing personal care is a skilled job, and ensure that this is reflected in policies relating to pay and conditions. In addition, we need to ensure there are opportunities for personal development and progression so people are able to use their skills and build a career within social care.

The idea of a National Care Service has been discussed and debated for a number of years as a potential way to deliver the reform needed. This kind of approach could achieve a great deal, particularly in terms of ensuring more consistency across services in different areas, and great certainty in terms of people’s expectations about the care they will receive and any costs they may face.

But as demonstrated by the numerous books and articles recounting the history of setting up the NHS, which will no doubt be revisited as part of the celebrations this week, establishing this kind of system will require a significant amount of work over many years to put everything in place.

So it’s crucial that opportunities to deliver change and improvements are not lost in the meantime. We’ve seen some positive steps in terms of policy and practice in Wales, but more action is still needed and could be delivered within existing systems and using existing levers.

And we can all – as we raise a metaphorical glass to the NHS – make sure we also remember to highlight and celebrate the positive difference that social care makes to our lives every day.