THE Government’s plan to fund improved health and social care has been broadly welcomed within the Church of England. Anti-poverty campaigners have said, however, that it will “add insult to injury” to younger, poorer families, who will suffer disproportionately from the increase.
A 1.25-per-cent increase in National Insurance contributions across the UK was announced by the Prime Minister on Tuesday, to be levied on employers and employees from April 2022. It will initially be used to fund reductions in NHS waiting lists, Boris Johnson argued.
Health and social-care systems are devolved to the four separate political administrations of Great Britain and Northern Ireland. Mr Johnson said that, while the new funding package was “to support those systems across the whole of the UK, the Government’s plan for health and adult social care identifies specific measures for England only.”
Over time, Mr Johnson said, a greater proportion of the £12 billion a year raised will go towards social care. This would allow a new cap on total care costs to be introduced. The plan is that, from 2023, no individual would pay more than £86,000 towards their care. From that year, the increase will appear on payslips as a health-and-social-care levy.
Tax on share dividends will also increase by 1.25 per cent; and, from 2023, pensioners still in work will also have to pay the rise, although there are just one million of those in England out of 12 million people of pension age.
The Bishop of Manchester, Dr David Walker, said: “Today’s announcement is very welcome, not least after 18 months in which social-care staff and residents have borne the brunt of the pandemic. I pray that this will be the first step towards a social-care system that will allow our most frail sisters and brothers to live in dignity and with an acceptable quality of life.
“Arguments may well continue about how such work should be paid for; for my own part, I am happy to see my taxes spent on the weakest in our society in this way.”
The Church of England’s medical-ethics adviser, the Revd Dr Brendan McCarthy, welcomed the cap on care costs that an individual will pay, and the increased funding for a problem which, he said, had been long in the making.
But he raised a concern that the funding for social care would not be in place for three years, as the initial money raised will go towards the NHS backlog. “We are acutely aware that systemic problems within our social-care system, made even more manifest by the pandemic, need to be addressed with real urgency,” he said.
“Over the past decade, we have seen eligibility criteria for individuals receiving care rise, effectively leaving very many people with care needs without necessary assistance. The social-care workforce is understaffed, underpaid, and under-appreciated. Care homes are operating under enormous pressure, and many residents pay excessive amounts for their care — in effect, subsidising the system.
“Inadequate social-care provision contributes to extra pressures on the NHS; this will undermine the additional funding for the NHS proposed by the Prime Minister.”
The Archbishops of Canterbury and York set up a commission earlier this year to reimagine care in the UK (News, 20 April). Dr McCarthy said: “We encourage the Government to act with similar scope and energy.”
In an interview on Radio 4’s Today programme on Thursday, Archbishop Welby described the Government’s social-care plans as “a beginning”.
He continued: “The question is not just how you pay for it: it’s about people, not money. Is this going to work? Is it going to mean that, overall, those in need of care are cared for really well and those of future generations find themselves going into a system that will look after them when they’re older?. . .
“If we, as it were, privilege the wealthy older against the poorest younger, that will not work. That’s not a people-centred policy. The policy needs to be centred on people, and needs to care for the poorest, as well as ensuring that we have an embedded system that will work and is acceptable to all.
“The test is not just in terms of money: the test is in terms of effectiveness. If it pushes more young people into poverty and means they can’t get their own house and things like that . . . that is going to be a really serious problem, and that is wrong. It needs to be done fairly between the generations. That’s part of intergenerational reconciliation. . .
“It sounds to me as though there’s a willingness to engage, but the detail is going to take a lot of working out, and we’re not there yet.”
The tax increase breaks a Conservative manifesto pledge; but Mr Johnson told MPs that no one had foreseen the global pandemic.
The Joseph Rowntree Foundation (JRF) estimates that two million families on low incomes will pay, on average, an extra £100 a year owing to the increase. Families in receipt of Universal Credit and Working Tax Credit are also facing a cut in October, when the £20 uplift — put in place during the Covid pandemic — ends.
The deputy director of evidence and impact at the JRF, Peter Matejic, said: “This extra cost adds insult to injury for these families who are facing a historic £1040 cut to their annual incomes when Universal Credit and Working Tax Credit are reduced in less than a month, on 6 October. If it presses ahead, this Government will be responsible for the single biggest overnight cut to social security ever.
“With inflation rising, the cost of living going up, and an energy price-rise coming in October, many struggling families are wondering how on earth they will be expected to make ends meet from next month.”
The Institute for Fiscal Studies said that the increase would raise the tax burden to its highest-ever sustained level.
From next April, those earning £24,100 a year will pay an additional £180 in National Insurance, and a higher-rate taxpayer on £67,100 will pay an additional £715. As income increases, however, the percentage share of National Insurance falls, as it is charged at just two per cent on salaries over £50,000. This means that the increase will have a proportionately smaller impact on the highest earners.
Members of the social-care sector have argued that the plans announced are inadequate to tackle the size and immediacy of the problem. The chief executive of the UK Home Care Association, Dr Jane Townson, said: “This is nowhere near enough. It will not address current issues, and some measures may create new risks.”
Mike Padgham, who chairs the Independent Care Group, said that it was a “huge opportunity missed for radical, once-in-a-generation reform of the social-care system”. It would not address the staffing crisis, which was “sending the sector into meltdown on a daily basis, as care providers struggle to cover shifts”.