Extra tax to fund the NHS or social care – why it doesn’t have to be one or the other

Here at SDSS, we work with our members and stakeholders to support the development of best practise around Self Directed Support (SDS). We are delighted when we hear examples of people getting the support they need, in a way that suits them [https://www.youtube.com/watch?v=Prks5_bzJL0]. Which is just as social care, delivered through the lens of SDS, should be. Far too often, however, we hear stories of people frustrated by a system that is failing them;

  • people having little to no choice due to a lack of services in their area
  • people finding it so hard to navigate a complex system with limited support that they give up altogether and instead fend for themselves (because there is not always enough money to fund fully fledged independent information and support services)
  • people accessing support only to discover that it is so limited (due to over stretched budgets that lead to tight Resource Allocation Systems) that, in fact, they get little more than the basics they need to live, not to have a life.

It is clear that in 2017 there are still numerous, complex challenges facing the social care system, those making use of it, and those working as part of it, and, it is also clear, that a large part of the problem is limited investment.

So, what to do? Pressure local authorities to better fund social care?  With what money? Pressure Scottish Government to better fund Local Authorities?  With what money? Set out a shared vision, based on the insight, experience, knowledge, expertise and passion of social care users, workers and leaders across the sector? And then hope that those in charge will sit up, take notice and find the money? 

Whilst politicians have minds and morals of their own, they may be more focussed when they see strong public support for any particular issue (so I’m told). A recent survey by the King’s Fund, https://www.kingsfund.org.uk/publications/what-does-public-think-about-nhs, said that ‘A clear majority (66%) of adults are willing to pay more of their own taxes to fund the NHS’, and I wonder how many of those adults fully understand the interplay between the NHS and social care? If they did, would they see that more money injected into social care would save millions for the NHS in the long term? Would they support that? And will those in positions of power seize the opportunity to help the public understand these complexities and ask for their support to do what is not just sensible, practical and necessary, but also simply right?

Since Christie, http://www.gov.scot/resource/doc/352649/0118638.pdf, we all know that the focus must be on prioritising preventative measures, and greater investment into social care has a crucial role here. But rights, and what is right, are even more important.  As a society, when we recognise that disability is created by the systemic barriers arising from our collective decisions and approaches, we also see that it is our collective responsibility to contribute to sustained public investment in the development of a modern, nationwide infrastructure of social care support. Of course, it is not just about money, and there is much more work to be done, but a focus on meeting only basic needs, driven by a necessity to make each pound stretch further, denies the wider thinking about the real role that social care has in our society today. Our Shared Ambition for the future of Social Care Support in Scotland http://www.socialcareambition.co.uk/ says that social care is about human rights, about having a life, about people being in control, about high expectations at a national level with the space for local flexibility, about a fairly treated, sustainable workforce and about the best use of public resources.  Mostly, social care is about equality.

Society as a whole may still have some growth to do here, but our leaders, no doubt, can take the current thinking on NHS funding and run with it. The right leadership, at every level, can help the public understand the natural conclusions from that line of thinking, that in a truly integrated system, greater taxation to better fund the NHS means ensuring enough of that money reaches social care and, in fact, is the only way to make integration of health and social care a genuine success.

What do you think? #soccareambition


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