"...the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped.”
– Last Speech of Hubert H. Humphrey
The first issue in adult social care is finance, with a recent announcement by Northamptonshire County Council that it would cease all new expenditure. Unlike the NHS, if a local authority overspends, someone goes to jail. Matching exponential demand with ever declining and inequitable funding is a challenge of unrivalled complexity when delivered within the political diversity of accountability to elected members at local level.
There has been increasing concern that financial pressures have focussed attention on statutory obligations and diluted the role of legitimate Leaders of Place, stewards of local democracy and champions of social justice.
Despite the redirection of increased funding to social care within already strained local authority budgets, there remains unmet need and unhelpful punitive financial penalties associated with delayed transfers of care.
The second issue is recruitment and retention of the workforce at all levels from care assistant apprentice to Director and beyond. Colleagues are choosing agency work to self-manage caseload and emotional burnout. The impact of the National Minimum /Living Wage and of Brexit are being articulated. There is increasing use of a ‘gig’ or zero hours type of employment. The Regulated Professions (Nursing, Social Worker, and Occupational Therapist) do not have parity of terms and conditions, or esteem with equivalent roles in the NHS, with predictable consequences. Indeed the entire workforce feels undervalued and yet we deal in the precious care of our most vulnerable.
The economic, societal, well-being and sustainability contribution of the sector remains poorly recognised. But, colleagues continue to prioritise social justice, remain true to public sector values and continually innovate to meet need for those in crisis. The narrative is mounting.
There are wonderful people at every level in Social Care, they should be treasured. The Government’s Social Care and Support Green Paper is awaited and comprehensive consultation is to be encouraged. There are no easy answers.