The chronic underfunding of social care cannot be ignored
The chronic underfunding of social care cannot be ignored © Peter Byrne/PA

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There has been no need to wait for an official inquiry into the British government’s handling of Covid-19 to conclude that the provision made for elderly care home residents at the start of the pandemic was woefully negligent. Amid real concern about a resurgence of the virus, ministers must now try to redeem themselves by ensuring the most vulnerable in society are henceforth properly safeguarded.

The dismal verdict on the initial phase has been confirmed by an investigation by parliament’s public accounts committee. Using language rarely found in such reports, the PAC said many elderly people were in effect “thrown to the wolves” when the pandemic hit. It identified failings of leadership, transparency and accountability. Nearly 20,000 care home residents died between early March and mid-June as long-term weaknesses in the social care system were compounded by the government’s “inconsistent and at times negligent approach”.

The sector, however, now faces a new shock as its chronically weak finances, the product of years of underfunding and broken promises of reform, face further damage. Care homes have seen residency rates fall steeply just as the need to make them safe against the further spread of Covid-19 has squeezed profit margins. This coincidence of underlying financial weakness, falling revenues and rising costs threatens to tip many over the edge into closure. The government must not repeat its mistakes and leave it too late to act effectively. For the short-term, the prime minister must now commit to provide central government emergency funding to supplement local authority payments over the coming year. This is the only way to keep homes open.

The risk is that the winter months will bring a resurgence of the virus alongside the arrival of often deadly seasonal flu. The pressures on care homes would have been intense at the best of times. Now it looks impossible to manage. If the NHS is not to be overwhelmed the government must make it clear it will underwrite directly the cost of sufficient, coronavirus-safe, care home places. There can be no repeat of the callous and deadly policy of pushing the elderly out of hospitals into conditions which put their lives in danger.

The options for long-term reform of social care to provide sufficient finance for care of the elderly have been well rehearsed, examined and re-examined for more than a decade in a stream of reports and studies. On his arrival in Downing Street Boris Johnson promised speedy action. So far that has turned out to be bluster. Broadly speaking, one reform road heads in the direction of compulsory private insurance schemes to put an end to the present lottery as to who bears the burden of filling the shortfalls in central government funding. The second points to integrating the financing of social care with that of the NHS, with more resources coming from general taxation or National Insurance levies.

Both approaches have their champions. Whatever the method of additional financing, there is a compelling case to break down the operational barriers between the NHS and social care. What cannot be gainsaid, though, is that the chronic underfunding of social care cannot any longer be ignored. Coronavirus was an unexpected shock, but it exposed years of wilful neglect by successive governments. Characteristically, Mr Johnson seems reluctant to apologise for the unnecessary deaths identified by the PAC. At the very least, he could redeem his promise to present a credible, properly funded system to ensure the nation properly looks after the elderly.

Letter in response to this editorial comment:

It’s time to end unfair funding of personal care / From Simon Hill, Southampton, UK

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