A review of England's adult social care sector has found that no single body is in charge, with successive governments accused of being "asleep at the wheel" over the crisis. Baroness Casey is set to unveil research showing the system is an "outlier" compared with countries such as France, Germany and Japan, lacking "clear system stewardship".
In a speech, she is expected to brand failings during the pandemic, which saw Covid-19 "spread like wildfire" in care settings, "a national shame".
Pandemic failures condemned
Baroness Casey is expected to say: "The Covid-19 Inquiry took apart the argument that a 'protective ring' had been thrown around care homes during the pandemic. Many old people died without their loved ones by their side. Many care workers left their jobs after what they had seen."
She is expected to add: "It is a national shame that this was allowed to happen. It should never happen again. Successive governments have been asleep at the wheel. In research we're publishing today the lack of 'stewardship' of social care comes through clearly. No one is in charge."
Baroness Casey is expected to make recommendations for sector reform by next summer.
Fragmented system exposed
The latest report, commissioned by her team and carried out by the Nuffield Trust and the Institute for Government think tanks, found adult social care in England is currently "a complex system" where responsibilities are shared between central government departments, arm's-length bodies and non-public sector providers.
It added: "Decision-making processes can be opaque and a single point of responsibility for overall oversight and stewardship is lacking. The consequences of this complexity and lack of clarity were highlighted during the Covid-19 crisis, and while that event forced some positive change, there remains a fundamentally fragmented system that lacks a coherent sense of direction."
Unlike NHS care, social care is not free at the point of use, and high costs sometimes mean people are forced to sell their homes to pay for what they need. People with savings worth more than £23,250 are not entitled to help with the cost of care from their local council.
Cost disparities and reform calls
The report warned of "poor transparency" around fees paid to and charged by providers, with people who have to pay for their own care charged, on average, 40% more for the same service than people whose care is arranged by their council.
Prime Minister Andy Burnham has suggested creating an NHS-style National Care Service and said he was willing to lose political capital over the issue. He has previously acknowledged "difficult, difficult decisions" could be needed on tax to fund it but insisted fixing the current problems in social care in England could save the NHS billions of pounds a year.
Shadow Health Secretary Damian Hinds MP said: "These findings highlight the challenges in social care and the need for meaningful reform that delivers a real difference to people's lives. Families deserve better than vague promises and announcements from Labour. Andy Burnham promised a national Care Plan, yet there is still little detail about what it would involve, how it would work or how much it would cost. Ministers must explain how the scheme will be funded and delivered, rather than leave Britons facing further Labour tax rises and saddling future generations with even more debt."
