Theresa May has been urged to show the same courage as Clement Attlee did when creating the NHS in order to fix the UK’s crumbling social care system.
In an exclusive interview, the head of the Care Quality Commission (CQC) told the prime minister that support for older people was now so threadbare that Britain’s status as a civilised society was diminished.
Since austerity began in 2010 under the coalition government people have become afraid they will be left isolated, without support or dignity in their old age, he added.
“It isn’t any way to treat our older people,” said David Behan, who stands down next week after six years as the CQC’s chief executive.
Behan praised the government’s decision to raise the NHS’s budget by £20bn by 2023-24 and said it would safeguard and stabilise the health service for years to come. But he told May that without similarly dramatic action on social care the NHS would remain woefully ill-equipped to meet the needs of the ageing population.
Behan also demanded major improvements to NHS mental health care. Long waits for treatment, problems with child and adolescent mental health services and bed shortages that forced patients to seek care hundreds of miles from home, were unacceptable, Behan said.
On social care, he challenged May, saying: “What’s disappointing, I have to say, is we’ve not seen a similar investment [to the NHS] in social care. The creation of the NHS by Attlee and [Aneurin] Bevan in 1948 took remarkable political courage and I think there will need to be remarkable political courage to [put] adult social care [on a stable footing].
“What we now need is a long-term funding settlement for social care which sits alongside the long-term funding settlement for the NHS.”
Behan said cuts to their central funding had led English councils to reduce the number of everyday services for older people, meaning increasing numbers were no longer getting washed, dressed or fed. About 1.2 million people in England who are in need of social care do not get it, he added.
May faced criticism during last year’s general election campaign after the Conservative manifesto did not include a cap on the amount of money people would have to pay to receive social care in their old age. She promised to expedite a long-term funding solution, though a government green paper setting out options has been delayed to the autumn.
While acknowledging that the politics of fixing social care were challenging, Behan said May and Jeremy Hunt, the health and social care secretary, must be as bold and decisive as their postwar forebears.
“This is about whether people in later years are treated with dignity and get the support they need to maintain their dignity,” he said. “It’s really a hallmark of a civilised society the way that we care for older people. I don’t think we should have a system where people should be fearful of growing older because there won’t be the services there to support them in the future.
“A more socially just society means people who are in their mid-80s who are isolated get the help they need to live an independent and fulfilled life. So I am calling for a bold and courageous settlement for future social care because we must address the quality and experience of care that older people receive.”
Behan did not disagree when asked if £2bn-£2.5bn would be necessary to shore up social care in the short term, a similar sum to that demanded by bodies such as Age UK and the Commons select committees covering health and social care and housing, communities and local government.
“I do think we need a short-term injection to keep the social care system operating and able to respond to the increase in demand,” Behan added.
A Department of Health and Social Care spokesperson said: “Our growing, ageing population is the defining challenge the NHS faces in its 70th year. Any solution to this must recognise that health and social care are two sides of the same coin and reforms must be aligned.
“That’s why we will publish our green paper on social care reform in the autumn alongside the long term NHS plan to ensure we have a world-leading health and social care system that works for everyone, now and in the future.”
Meanwhile, NHS leaders have warned that the £20bn increase is not enough to fund major improvements to key services such as cancer, mental health and maternity care.
Chris Hopson, chief executive of NHS Providers, which represents NHS trusts in England, told MPs on Monday that all of the extra money would be swallowed up by hospitals improving key NHS treatment waiting times and also covering their deficits.
Niall Dickson, chief executive of the NHS Confederation, said ministers should “lower expectations” about how much improvement the NHS could deliver with the £20bn.
In his evidence to the Commons health and social care select committee NHS England chief executive Simon Stevens said that food companies need a “wake-up call” on the amount of sugar they put in their products or the government’s ambition of halving childhod obesity by 2030 will not be met.
