3rd August, 2020

“Slow, inconsistent and negligent” – but can social care be Boris Johnson’s legacy?

By GK Account Manager and social care policy expert, Jack Sansum

For successive leaders and political parties social care has been politically toxic. From Labour’s 2010 “death tax” to the Tories 2017 “dementia tax”, during the past 22 years, the question of how to improve social care has been explored in 12 “white” or “green” papers or major government consultations, four independent reviews or commissions and numerous parliamentary inquiries.

Indeed, it is now over a year since Boris Johnson stood outside Downing Street promising to “fix the crisis in social care once and for all”. While Johnson previously planned talks within the first 100 days of his administration, aimed at finding a cross-part solution to the issue, the COVID-19 pandemic has turned a medium-term policy goal into an urgent priority.

COVID-19 and the need for a “clear plan”

The COVID-19 crisis has laid out in stark terms the need for social care reform. There have been more than 25,000 excess deaths among care home residents, with care workers having the highest death rate of any occupational group.

A recent report by the Parliamentary Accounts Committee, highlighted that the crisis has revealed the “tragic impact” of delays by successive governments to reform the social care sector. The Committee found that problems in the sector have been compounded by a lack of leadership, accountability, and centralised control for social care. They have called on the Government to publish a “3-point plan” by September, ahead of a potential second wave of COVID-19 infections.

A “Big Bang” blueprint for reform

Reports from Whitehall indicate that Johnson is determined to deliver on his commitment to “tackle the injustice of social care” and to put in place a new funding system to “give every older person the dignity and security they deserve”.

Johnson has drafted in David Cameron’s former policy chief Camilla Cavendish to help finalise these plans, while Rachel Wolf, the policy adviser who co-wrote last year’s Conservative manifesto, has been brought into the Department for Health and Social Care (DHSC) to oversee a “Big Bang” blueprint for reform.

Once such reform could see social care being brough under the control of NHS England, taking responsibility away from councils in England – together with £22.5bn in annual funding. The move, which would swell the health service’s budget to £150bn, would see services commissioned and budgets controlled by embryonic regional integrated care systems (ICSs). However, legislation would be required to implement such a change, with ICSs still to obtain legal standing.

Funding for a reformed system could see those over-40 in the UK pay an increased level of tax to cover the cost of care in later life. Health Secretary Matt Hancock is an advocate of such a plan, however, in order to succeed with plans for reform, Johnson will need to build cross-party consensus with Labour and the Liberal Democrats who are currently seeking assurances from the Government on significant funding increases, changes to immigration rules and the workforce crisis.

A 73rd year birthday present?

With plans for reform of the sector appearing to finally be back on the agenda in Whitehall, policy proposals are likely to be examined by a new health and social care taskforce and DHSC, providing significant scope for social care providers to shape the structure and mechanisms of the plans.

To engage with the Government’s plans for reform effectively, organisations will need to understand the wider direction of health and social care policy. Health and social care is GK Strategy’s largest policy area and we are expert at supporting organisations who are operating in highly regulated sectors and helping them to navigate complex markets and build relationships with key decision makers.

With the Government signalling its intention to deliver on its commitment to shake up the social care system, there are plenty of opportunities for social care providers to benefit.

For more information or if you would like to speak to the GK team, please contact: Jack Sansum on