Councils and Coronavirus: What Next for Social Care

Elliot Bidgood discusses what COVID-19 has meant for local government, focusing on the impact on social care and what Labour should do next

Since the onset of coronavirus, few sectors of British society have been hit harder than adult social care. Councils have spent 48% of the £3.2bn emergency funding allocated by central government – a drop in the ocean against what is needed - on social care, while the human cost has been severe. COVID-19 has been officially linked to the deaths of 19,394 care home residents and 268 social care workers since the beginning of March, and excess deaths are up 78% against the same time in 2019. It is right that Keir Starmer has now called for the tragedy in social care to be a key focus of an independent inquiry into the government’s handling of the pandemic, to uncover why the promised “protective ring” around care homes was breached.

However, Labour councillors have voiced a feeling that social care was a neglected ‘cinderella service’, long before COVID-19. Care work as a profession has been underpaid and written off as ‘low-skilled’, and the lack protection afforded to them during this crisis is fundamentally a Black Lives Matter issue too. 1 in 5 adult care workers are BAME (this rises to 67% in London) and care worker fatalities have fallen disproportionately on them. And Conservative failures and successive Labour election defeats have meant we lack a National Care Service or any other system that can ensure adequate funding and a clear principle for public access, leaving it a poor relation to the NHS that loads costs onto individuals and families. In 2019, public satisfaction with social care stood at 29%, against 60% for the health service.

With inadequate central government support, local authorities have had to innovate to deliver effective and safe care services amid COVID-19. One council leader reported that initial government guidance was delayed, and eventually consisted of telling them “what they had already worked out” in the meantime. In London, the North Central Proud to Care scheme – a partnership between boroughs promoting health and care as a career option – was extended to the entire capital and boosted by Sadiq Khan, drawing 2,000 applications to meet capacity challenges. Faced with critical delays in the rollout of the central procurement system, Labour councils in London and Merseyside formed partnerships amongst themselves and with local businesses in order to procure adequate PPE.

Councils have also had to consider how to ensure safe discharge of patients from hospital, especially when testing equipment was scarce and many care home providers were reluctant to take risks. Brent quarantined residents in a dedicated care home to prevent infections in transition, for example. Birmingham City Council reached out to care providers to reduce turnaround times, offering to amend contracts if necessary, and provided one-off payments to cover the cost of implementing COVID-19 measures that were needed to safely maintain Discharge to Assess (D2A) pathways to care homes or community settings.

When the crisis is over and we return to ‘normality’, councils and partner care providers should conduct a thorough accounting of which innovations in service delivery, staffing and procurement have worked, which should only ever have been temporary, and what other lessons can be learned. Patients, residents and care workers should be a central part of that conversation – there’s a reason that services built around co-operative principles can boast higher satisfaction ratings, better investment and lower staff turnover.

Moreover, there is a widespread feeling in the nation that we must now honour our care workers as part of a new post-crisis settlement. While acknowledging that Labour authorities such as Hackney and Islington have shown leadership in implementing a real living wage for care workers, shadow minister for social care Liz Kendall put it well when she told a Zoom meeting of Labour Co-op councillors that “we may as well pack up and go home” if the labour movement can’t make this a national priority too, as well as investing more in key worker housing.

All of this will need to be underpinned by a new funding model to ensure access and bridge the gap between health and social care, and Labour’s new leadership is still developing its policy offer here. But if nothing else, this crisis has returned the spotlight to social care and shown that both local government and care workers must have a key voice in the party’s evolving discussion.

Elliot Bidgood is Secretary of the Young Fabians Devolution and Local Government Network. He is based in Hackney and currently works as a research and communications freelancer, mainly in the not-for-profit sector.

He tweets at @ElliotBidgood

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