BRIEFING PAPER Number 8001, 21 February 2020 Adult social care: policy

developments under the By Tim Jarrett

current Government (England) Contents: 1. The situation inherited by the Conservative Government 2. May 2015 – July 2016: David Cameron 3. July 2016 – July 2019: 4. July 2019 – to date:

www.parliament.uk/commons-library | intranet.parliament.uk/commons-library | [email protected] | @commonslibrary 2 Adult social care: policy developments under the current Government (England)

Contents

Summary 3 1. The situation inherited by the Conservative Government 4 2. May 2015 – July 2016: David Cameron 6 2.1 April 2015 – General Election commitments 6 2.2 July 2015 – Deferral until April 2020 of cap and more generous means-test 6 2.3 November 2015: £3.5 billion additional funding 7 3. July 2016 – July 2019: Theresa May 8 3.1 December 2016 – £900 million additional funding 8 3.2 March 2017 – social care Green Paper and additional £2 billion funding 8 3.3 May 2017 – General Election commitments 9 3.4 June 2017 – Queen’s Speech 10 3.5 July 2017 – 1st delay to the Green Paper 10 3.6 November 2017 – 2nd delay to the Green Paper 10 3.7 December 2017 – indefinite postponement of cap and more generous means- test 10 3.8 January 2018 – creation of the Department of Health and Social Care 11 3.9 February 2018 – additional £150 million funding 11 3.10 June 2018 – 3rd delay to the Green Paper 12 3.11 October 2018 – 4th delay to the Green Paper 12 3.12 October 2018 – additional funding of up to £650 million in 2019/20 12 3.13 December 2018 – 5th delay to the Green Paper 12 3.14 April 2018 – 6th delay to the Green Paper 13 4. July 2019 – to date: Boris Johnson 14 4.1 July 2019 – first speech as Prime Minister 14 4.2 July 2019 – Green Paper reportedly dropped 14 4.3 September 2019 – £1.5 billion of additional funding, and £2.5 billion of existing funding rolled-over 15 4.4 November 2019 – General Election commitments 16 4.5 January 2020 – PM: reforms “within this Parliament” 17 Other Library briefing papers on adult social care 19

Cover page image copyright Wheelchair / image cropped. No attribution required

3 Commons Library Briefing, 21 February 2020

Summary

This House of Commons Library briefing paper provides a summary of the social care measures taken under the three Prime Ministers since the Conservative Government was first returned in 2015. In particular, the note considers both the increases in central government funding for social care, and also its approach to reform of social care. The current situation is that a social care plan will be brought forward during this year – although it is not clear in what form this will take (the May Government had proposed a consultative Green Paper, for example) – and reform to social care will be implemented during this Parliament, as stated in January 2020 by the Prime Minister. This note summarises more detailed Library briefing papers, including the papers covering the funding of adult social care, and the Government’s ongoing policy review, to provide a quick glance view to the social care policies under David Cameron, Theresa May and Boris Johnson. This note applies to England only. A full list of Library briefings on adults social care can be found at the end of this note.

4 Adult social care: policy developments under the current Government (England)

1. The situation inherited by the Conservative Government

Reform of social care funding had been sitting in the Government’s “in box” for some fifteen years by the time a majority Conservative Government came to power at the May 2015 General Election. The 1997–2010 Labour Government had appointed the Royal Commission on Long Term Care for the Elderly, whose report of March 1999 called for free personal care to be introduced and a significantly more generous means-test, among other measures. While some of its proposals were implemented, on these points in particular the Labour Government rejected them, citing the cost. While further proposals were subsequently put forward by the Government itself, fundamental change was not implemented during the remainder of the Labour administration. Following the May 2010 General Election, a Coalition Government composed of Conservative and Liberal Democrat MPs came to power, led by the Conservative Party leader David Cameron as Prime Minister. The new Government swiftly established the Commission on the Funding of Care and Support, chaired by Andrew Dilnot in July 2010. A year later, the Commission published its proposals, centre among which were the introduction of a cap on lifetime social care charges and a significantly more generous means-test. The then Government accepted these proposals in principle, although they altered the parameters for the cap and the means-test, as well as some of the detailed policy behind the cap. The Care Act 2014 provided the legislative changes to implement the novel policies proposed by the Commission, and an implementation date of April 2016 was set. The country went to the polls for the May 2015 General Election, and a majority Conservative Government was returned.

Box 1: How do people pay for social care at present? While the NHS is mostly free at the point of use (except e.g. dentistry, prescriptions for some groups), this is not the case for social care, something that many people do not realise until they, or a relative or friend, need social care. A means-test is applied to determine if someone requiring social care support is eligible for local authority funding support. At present, care home residents with capital (which may include the value of their home) below £23,250 are eligible for such support, but have to contribute their income (and some of their capital if in excess of £14,250) towards the cost on an ongoing basis without limit. Even then, if their income exceeds what a local authority usually pays for a care home place, they may find themselves ineligible for financial help. For those receiving social care in other settings, such as at home, local authorities can establish their own frameworks for charging (if they decide to charge) which must be at least as generous as the care home means-test. A key difference is that the value of a person’s home is always excluded (or “disregarded”) from the domiciliary care means-test. 5 Commons Library Briefing, 21 February 2020

There is no limit to the amount an individual can spend on social care funding during their lifetime, which can lead to ”catastrophic” social care bills of tens of thousands of pounds for some people. However, if someone qualifies for NHS Continuing Healthcare because their needs are primarily health- related, then both their health and social care costs are met in full by the NHS without any financial contribution required at the point of use from the person receiving the care. Further information can be found in the Library briefing papers Social care: paying for care home places and domiciliary care (England) and NHS Continuing Healthcare in England.

6 Adult social care: policy developments under the current Government (England)

2. May 2015 – July 2016: David Cameron

The May 2015 General Election returned a Conservative majority Government, led by Prime Minister David Cameron.

2.1 April 2015 – General Election commitments The Conservative Party’s manifesto for the 2015 General Election stated that a Conservative Government, if elected, would implement the lifetime cap on social care charges to the timescale set by the Coalition Government. On the first page of text in the Manifesto, under the heading “we have a plan for every stage of your life”, the document stated: “we will cap the amount you can be charged for your residential care”. 1 Further detail was provided later in the document: We will cap charges for residential social care from April 2016 and also allow deferred payment agreements, so no one has to sell their home. For the first time, individual liabilities will be limited, giving everyone the peace of mind that they will receive the care they need, and that they will be protected from unlimited costs if they develop very serious care needs – such as dementia. 2

2.2 July 2015 – Cap and more generous means-test delayed until April 2020 Two months after the 2015 General Election, the newly-elected majority Conservative Government announced that the introduction of the lifetime cap – plus the more generous means-test and other “Phase 2 reforms” of the Care Act 2014 – would be “delayed”. This also affected the introduction of local authority brokering on behalf of self- funded care home residents, and first-party top ups. All of these changes had been due to be introduced in April 2016. In a written statement, the then Parliamentary Under-Secretary of State at the Department of Health, Lord Prior of Brampton, announced that “we have taken the difficult decision to delay the introduction of the cap on care costs system until April 2020”, adding that it was “not a decision that has been taken lightly”. The estimated £6 billion cost of the new policy over five years was one reason: the Minister said “a time of consolidation is not the right moment to be implementing expensive new commitments such as this, especially when there are no indications the private insurance market will develop as expected”. He also highlighted the “genuine concerns

1 Conservative Party, Strong Leadership. A Clear Economic Plan. A Brighter, More Secure Future, April 2015, p3 [via Lancaster University, University Centre for Computer Corpus Research on Language] 2 As above, pp65 and 67 7 Commons Library Briefing, 21 February 2020

raised by stakeholders” (i.e. local authorities and partners) regarding the implementation of the changes as a further reason. Noting that the cap had been proposed by the Care and Support Commission, the Minister stated that the Government “still accepts that recommendation and remains firmly committed to delivering this historic change”.3

2.3 November 2015: £3.5 billion additional funding In his Spending Review and Autumn Statement, the then Chancellor of the Exchequer, George Osborne, announced additional funding for social care up of to £3.5 billion: In future those local authorities that are responsible for social care will be able to levy a new social care precept of up to 2% on council tax. The money raised will have to be spent exclusively on adult social care, and if all authorities make full use of it, it will bring almost £2 billion more into the care system … I am today increasing the better care fund to support that integration, with local authorities able to access an extra £1.5 billion by 2019-20.4

3 HLWS135 17 July 2015 4 HC Deb 25 November 2015 cc1363–1364 8 Adult social care: policy developments under the current Government (England)

3. July 2016 – July 2019: Theresa May

Following the resignation of David Cameron in the light of the June 2016 referendum on the UK’s membership of the European Union, Theresa May became Prime Minister in July 2016 after winning the backing of the majority of Conservative MPs. In the subsequent June 2017 General Election, the Conservative Party lost its majority but remained in power through a “confidence and supply” agreement with the Democratic Unionist Party (DUP).5

3.1 December 2016 – £900 million additional funding After the November 2016 Autumn Statement – in which the then Chancellor, , did not provide funding for (or even mention) social care6 – a month later the Government did announce a further £0.9 billion of funding for social care in the English Provisional Local Government Finance Settlement 2017/18. The then Secretary of State for Communities and Local Government, Sajid Javid, explained that, of this, £240 million would be provided as a new, dedicated, Adult Social Care Support Grant in 2017-18. Mr Javid said that it would be “distributed fairly according to relative need”.7 In addition, changes to the social care Council Tax precept would allow local authorities to increase the maximum permissible precept from 2% to 3% in 2017/18 and 2018/19, so allowing local authorities to achieve the maximum 6% over the period 2017/18–2019/20 a year early, in the process raising an additional £677 million (compared to having 2% precepts in each of the three years).8

3.2 March 2017 – announcement of a planned social care Green Paper, and additional £2 billion funding In his Budget Statement given on 8 March 2018, the then Chancellor told the House that “the Government will set out their thinking on the options for the future financing of social care in a Green Paper later this year”.9 The then Health Minister, Philip Dunne, told the House later in

5 Cabinet Office, Confidence and Supply Agreement between the Conservative and Unionist Party and the Democratic Unionist Party, policy paper, updated 23 January 2020 6 HC Deb 23 November 2016 cc899–910. Similarly, there was no mention of social care in the accompanying document published by HM Treasury (HM Treasury, Autumn Statement 2016, Cm 9362, November 2016) 7 HC Deb 15 December 2016 c977 8 For more information, see page 22 of the Library briefing paper, Adult Social Care Funding (England). 9 HC Deb 8 March 2017 c818 9 Commons Library Briefing, 21 February 2020

March 2017 that “it would be fair to say that it is expected to be published in the summer”.10 The Budget “Red Book”, published by HM Treasury, added further details on the rationale for a Green Paper: In the longer term, the government is committed to establishing a fair and more sustainable basis for adult social care, in the face of the future demographic challenges set out in the OBR’s [Office for Budget Responsibility] Fiscal Sustainability Report. The government will set out proposals in a green paper to put the system on a more secure and sustainable long term footing.11 Mr Hammond also told the House that he was “committing additional grant funding of £2 billion to social care in England over the next three years; that is £2 billion over the next three years, with £1 billion available in ’17-18”, explaining that this “forms a bridge to the better care funding that becomes available towards the end of the Parliament”.12 This increased the improved Better Care Fund (iBCF) for adult social care to: £1.1 billion in 2017/18, £1.5 billion in 2018/19 and £1.8 billion in 2019/20.13

3.3 May 2017 – General Election commitments Having committed to publishing a new social care Green Paper, when Theresa May called a snap General Election for June 2017 the Conservative Party’s manifesto provided a clearer picture of the Government’s likely position. The manifesto, published on 18 May, included the following points: • a more generous, single means-test capital limit of £100,000; • “so that people are looked after in the place that is best for them”, the manifesto proposed to “align the future basis for means-testing for domiciliary care with that for residential care” – this would mean that for those receiving domiciliary care the value of their home would be included in the means-test (at the time this only applied to care home residents, as continues to be the case); • on a related point, the extension of the deferred payments agreement scheme to those receiving domiciliary care whose home is included in the means-test; • a commitment to publish a Green Paper on social care; • a cap on lifetime social care charges would not be introduced.14

10 HC Deb 14 March 2017 c48WH 11 HM Treasury, Spring Budget 2017, HC1025 2016-17, 8 March 2017, p47, para 5.6 12 HC Deb 8 March 2017 c820 13 Ministry of Housing, Communities and Local Government, Core spending power: final local government finance settlement 2018 to 2019 – Supporting Information, 6 February 2018 14 Conservative Party, Forward, Together – Our Plan for a Stronger Britain and a Prosperous Future, May 2017, p65 10 Adult social care: policy developments under the current Government (England)

On this last point, the then Health Secretary, Jeremy Hunt, confirmed on the day of the manifesto’s launch that: not only are we dropping it [the cap] but we are dropping it ahead of a General Election and we’re being completely explicit in our manifesto that we’re dropping it.15 However, following criticism of the proposals, on 22 May 2017 the then Prime Minister stated that the cap had not been dropped – contending “nothing has changed” – and that an “absolute limit” on how much people have to pay for social care would be proposed in the planned Green Paper.16

3.4 June 2017 – Queen’s Speech The Queen’s Speech in June 2017 included that “my Ministers will work to improve social care and will bring forward proposals for consultation”.17

3.5 July 2017 – 1st delay to the Green Paper Having said in March 2017 that the Green Paper would be published by the summer of 2017, a delay until the end of 2017 was announced by the Government shortly after the General Election.18

3.6 November 2017 – 2nd delay to the Green Paper In November 2017, the Minister then responsible for the Green Paper said that it would be published “by summer recess 2018”, a reference to Parliament’s summer recess (which started on 25 July 2018).19

3.7 December 2017 – indefinite postponement of cap and more generous means-test As noted above, when the Conservative Government announced in July 2015 that the introduction of the Stage 2 changes under the Care Act 2014 – including the lifetime cap on social care charges – would be not implemented in April 2016 as planned, they stated that the changes were being delayed until April 2020. In December 2017, the Government said that the April 2020 implementation date would also not be achieved, but did not set a new timetable, in effect indefinitely postponing the introduction of the Stage 2 changes.

15 BBC Radio 4, Today, 18 May 2017 (at 2:15:11); see also “Theresa May ditches manifesto plan with 'dementia tax' U-turn”, , 22 May 2017 16 Welsh Conservatives, Theresa May: Speech at the Welsh Conservative Manifesto Launch, 22 May 2017 17 HL Deb 21 June 2017 c6, see also 10 Downing Street, The Queen’s Speech and Associated Background Briefing, on the Occasion of the Opening of Parliament on Wednesday 21 June 2017, 21 June 2017, p58 18 HL Deb 6 July 2017 c987 19 HCWS258 16 November 2017 11 Commons Library Briefing, 21 February 2020

With the Green Paper expected (at that stage) to be published by the 2018 summer parliamentary recess, in a statement to the House the then Parliamentary Under-Secretary of State for Health, Jackie Doyle- Price, said: To allow for fuller engagement and the development of the approach, and so that reforms to the care system and how it is paid for are considered in the round, we will not take forward the previous Government’s plans to implement a cap on care costs in 2020. Further details of the Government’s plans will be set out after we have consulted on the options [i.e. following the consideration of responses to the Green Paper]. 20

3.8 January 2018 – creation of the Department of Health and Social Care As part of a Government reshuffle, in January 2018 the post of Secretary of State for Health was retitled as the Secretary of State for Health and Social Care, and concomitantly, the Department of Health was renamed the Department of Health and Social Care (DHSC). This move followed the announcement that responsibility for the social care Green Paper would move to the new DHSC from the Cabinet Office.21 It should be noted that the Department of Health had long been responsible for adult social care and social services policies in any case22 – the delivery of social care remained the responsibility of local authorities with funding provided by the Ministry for Housing, Communities and Local Government (MHCLG).23

3.9 February 2018 – additional £150 million funding In his February 2018 written parliamentary statement outlining the annual local government finance settlement for local authorities in England, the then Secretary of State for Housing, Communities and Local Government announced a further £150 million of funding for social care. Mr Javid told the House that, “having listening to representations since the provisional settlement”, he was announcing “a further £150 million in 2018-19 for an Adult Social Care Support Grant”. It would be funded by an “anticipated underspend in existing departmental budgets” and would be allocated “according to relative needs”.24

20 HC Deb 7 December 2017 c1235 21 The Green Paper was originally the responsibility of the Department of Health, before transferring to the Cabinet Office in November 2017, where it was the responsibility of the then First Secretary of State, Damian Green. In January 2019, responsibility for it transferred to the Health and Social Care Secretary. 22 The Department for Education is responsible for children’s social care and social services policies. 23 Previously called the Department for Communities and Local Government (DCLG) prior to January 2018. 24 HCWS451 6 February 2018 12 Adult social care: policy developments under the current Government (England)

3.10 June 2018 – 3rd delay to the Green Paper A further delay to the Green Paper’s publication was announced by the then Health and Social Care Secretary, Jeremy Hunt, in June 2018. Citing the recent announcement that there would be a new NHS Plan, Mr Hunt contended that “because we want to integrate plans for social care with the new NHS plan, it does not make sense to publish it before the NHS plan has even been drafted”. Therefore, he added “we now intend to publish the social care Green Paper in the autumn around the same time as the NHS plan”.25

3.11 October 2018 – 4th delay to the Green Paper After the summer parliamentary recess, reference to publication in the autumn was replaced to “later in the year”,26 and, as stated by the Health and Social Care Secretary, “before the end of the year”.27

3.12 October 2018 – additional funding of up to £650 million in 2019/20 At the start of October 2018, the recently appointed Health and Social Care Secretary, , announced £240 million of additional funding for the remainder of the 2018/19 financial year for social care to help deal with the anticipated winter pressures that the NHS would face (e.g. bed blocking).28 In his 28 October 2018 Financial Statement, the then Chancellor told the House that, ahead of the social care Green Paper that would make “our social care system sustainable into the future”, to deal with the “immediate pressures local authorities face in respect of social care” a further “£650 million of grant funding for English authorities for 2019- 20” would be made available:29 • a further £240 million for adult social care to help deal with winter pressures on the NHS; • £410 million for both adult and children’s social care – local authorities would determine how to allocate their share of the pot between the two.30

3.13 December 2018 – 5th delay to the Green Paper In mid-December 2018, the Government said, “given wider events” (such as -related matters31), that it “will be publishing the Adult

25 HC Deb 18 June 2018 c52 26 HL Deb 16 October 2018 c391 27 HC Deb 17 October 2018 c733 28 Department of Health and Social Care, £240 million social care investment to ease NHS winter pressures, 2 October 2018 29 HC Deb 29 October 2018 c657 30 HM Treasury, Budget 2018, HC1629 2017–19, October 2018, p75, paras 5.15–5.16 31 “Brexit has delayed plans to deal with adult social care crisis, minister admits”, Evening Standard, 12 February 2019 13 Commons Library Briefing, 21 February 2020

Social Care Green Paper at the earliest opportunity in the new year”.32 During the debate that accompanied the publication of the NHS Long- Term Plan in January 2019, Mr Hancock made a fresh commitment in regard to a social care Green Paper, saying on the matter of its publication: “I certainly intend that to happen before April”.33

3.14 April 2018 – 6th delay to the Green Paper The Green Paper remained unpublished during the spring of 2018, despite the Health and Social Care Secretary having said that he “certainly intend[ed]” for it be published “before April”. No explanation was offered by the Government for the latest missed publication date in response to a parliamentary question, and no specific date was set, only that it would be published “at the earliest opportunity”.34

32 PQ 199475 13 December 2018 33 HC Deb 7 January 2019 c69 34 PQ 248593 2 May 2019 14 Adult social care: policy developments under the current Government (England)

4. July 2019 – to date: Boris Johnson

Following the resignation of Theresa May, Boris Johnson was elected leader of the Conservative Party by its members, and so become Prime Minister. In December 2019, a General Election returned Mr Johnson’s Government with an overall majority of 80 seats in the House of Commons.

4.1 July 2019 – first speech as Prime Minister In Boris Johnson’s first speech as Prime Minister on 24 July 2019, he said: My job is to protect you or your parents or grandparents from the fear of having to sell your home to pay for the costs of care and so I am announcing now – on the steps of Downing Street – that we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve.35 No indication was given by the Prime Minister as to when the plan – seemingly already prepared – would be published. While the Prime Minister referred to the “crisis in social care” for older people, he did not mention social care for other adults – in England, the total cost to the public purse of meeting the social care needs of adults under 65 years of age matches that for those aged 65 and over.36

4.2 July 2019 – Green Paper reportedly dropped On 31 July 2019, the Financial Times reported that “a consultative paper that laid out options for funding care for elderly and disabled people but which had languished unpublished as Brexit consumed ministerial attention” – presumably the social care Green Paper – had “already been ditched”. The reason cited was that the new Prime Minister “sought to inject more urgency into the process”. In its place, the FT reported, would be a White Paper, the publication of which was “expected in the autumn” and would propose “a clear course of action to address the crisis”.

35 10 Downing Street, Boris Johnson's first speech as Prime Minister: 24 July 2019, 24 July 2019 36 The Institute for Fiscal Studies (IFS) and the Health Foundation have noted in May 2018 that the adult social care budget is split almost equally on those aged 65 and over, and those under 65, because “recipients of care under the age of 65 tend to have higher costs than individuals aged 65 and over … In England, adults aged 18−64 represented 33% of adult social care recipients but accounted for half of all spending on adult social care” [Institute for Fiscal Studies and The Health Foundation, Securing the future: funding health and social care to the 2030s, May 2018, p11 and footnote 15]. 15 Commons Library Briefing, 21 February 2020

Supporting this is the fact that, since Mr Johnson became Prime Minister, all reference to a social care Green Paper has been dropped from answers given to parliamentary questions on the topic of the reform of social care.37 Indeed, when asked directly when the Government “plans to publish the green paper on funding social care”, the then Minister for Care, Caroline Dinenage, told the House in September 2019: The Government will set out a plan to fix the care system and give every older person the dignity and security they deserve. We will set out our proposals in due course.38 A similar response was given in January 2020 to the same question.39

4.3 September 2019 – £1.5 billion of additional funding, and £2.5 billion of existing funding rolled-over In his Spending Round statement in September 2019, the then Chancellor, Sajid Javid, told the House: The Prime Minister has committed to a clear plan to fix social care and give every older person the dignity and security that they deserve. I can announce today that councils will have access to new funding of £1.5 billion for social care next year [2020/21] … on top of the existing £2.5 billion of social care grants. Mr Javid described it as a “solid foundation to protect the stability of the system next year” and a “a down payment on the more fundamental reforms that the Prime Minister will set out in due course”.40 The accompanying Treasury document explained that the £1.5 billion of new social care funding for 2020/21 was composed of: • £1 billion for adult and children’s social care.41 As in 2019/20, it will be for individual local authorities to determine how much of their share of this funding to spend on adult or children’s social care; • up to £500 million raised by local authorities should they implement a further 2 per cent adult social care Council Tax precept. In terms of the £2.5 billion rolled over from 2019/20, the King’s Fund noted that this was composed of: • £1.8 billion from the improved Better Care Fund (iBCF); • £410 million from the social care support grant in for adult and children’s services; and

37 For example, references were still being made to the publication of a social care Green Paper under Ms May’s leadership shortly before Mr Johnson became Prime Minister, see PQ 272233 10 July 2019. 38 PQ281725 9 September 2019 39 PQ7622 29 January 2020 40 HC Deb 4 September 2019 cc183–184 41 HM Treasury, Spending Round 2019, CP170, September 2019, p9, para 2.3 16 Adult social care: policy developments under the current Government (England)

• £240 million from the winter pressures grant for adults.42 4.4 November 2019 – General Election commitments In their manifesto for the December 2019 General Election, the Conservative Party said “we need a long-term solution for social care” and said that it was “committing to an ambitious three-point plan”: 1) £1 billion extra of funding every year for more social care staff and better infrastructure, technology and facilities. 2) We will commit to urgently seek a cross-party consensus in order to bring forward the necessary proposal and legislation for long-term reform. 3) The prerequisite of any solution will be a guarantee that no one needing care has to sell their home to pay for it.43 On this final point, this appears to make a significant departure from the current means-test. At present, the value of someone’s home is only included in the means- test if they are receiving social care in a care home setting, although it must be disregarded from the means-test if a partner or (in some cases) a relative continues to live there. If it is included in the means-test, then in many cases a deferred payment agreement can mean that a care home resident doesn’t have to sell their home during their lifetime – however, upon their death, the house is sold and the proceeds used to repay the local authority that had been funding the care home place through, in effect, a loan to the care home resident secured on the value of their home. According to the Institute for Fiscal Studies (IFS), “the Conservatives did say: that housing would not be counted in means-tests, so that no one has to sell their house in order to pay for the cost of their care, even after they die”.44 The manifesto set out the Party’s principles in its approach to the question of funding social care: We need to have a system to give every person the dignity and security that they deserve. This is a significant and complex challenge and in order to lay the foundations, we must plan for the infrastructure, workforce growth and healthcare integration that is required for a care system fit for the 21st century. Because this is a long-term problem that will affect so many people, any solution has to be able to survive long-term. We must build the same level of consensus on social care as we have already built on the NHS. So we will build a cross-party consensus to bring forward an answer that solves the problem, commands the widest possible

42 King’s Fund, Five numbers to sum up the Spending Round for health and social care, 6 September 2019 43 Conservative and Unionist Party, Get Brexit Done – Unleash Britain’s Potential, November 2019, p12 44 Institute for Fiscal Studies, What do the election manifestos mean for local government funding?, 2 December 2019 17 Commons Library Briefing, 21 February 2020

support, and stands the test of time. That consensus will consider a range of options but one condition we do make is that nobody needing care should be forced to sell their home to pay for it. The policy proposals set out in the manifesto for social care were: • “confirming” the addition £1 billion funding announced in autumn 2019 for 2020/21 “in every year of the new Parliament” (as noted above, the £1 billion funding for 2020/21 is provided for both adult and children social care – it’s not clear if this will continue to be the case in later years); • “extend the entitlement to leave for unpaid carers, the majority of whom are women, to one week”; • “£74 million over three years for additional capacity in community care settings for those with learning disabilities and autism”.45

4.5 January 2020 – PM: reforms “done within this Parliament” On 14 January 2020, the Prime Minister was questioned about the reform of social care. During the interview on BBC Breakfast, Mr Johnson was challenged that he had said in July 2019 that he already had a plan for social care reform, and was asked “where is that plan”, to which he replied: We will be bringing forward a plan this year but we will get it done within this parliament. The Prime Minister also highlighted the scale of the challenge: It’s a big big thing, I mean this is a potentially massive change in the way we fund social care and we’ve got to get it right and we’re got to think very carefully about how we do it because there’s lot of really quite important moral and social issues contained within it. You know: should taxpayers be paying for people who might be able to afford it, what is the relationship between families that you want to encourage, should families be looking after their elderly relatives, you know, all these are very complex questions but the key thing is that everybody must have dignity and security in their old age, no one should sell their home to pay for their cost of their care, and we will do that.46

45 Conservative and Unionist Party, Get Brexit Done – Unleash Britain’s Potential, November 2019, p12 46 BBC, The Big Interviews: Boris Johnson on BBC Breakfast, (at 16 minutes 25 seconds), 14 January 2020 18 Adult social care: policy developments under the current Government (England)

19 Commons Library Briefing, 21 February 2020

Other Library briefing papers on adult social care

• Social care: paying for care home places and domiciliary care (England) • Adult social care: the Government’s ongoing policy review and anticipated Green Paper (England) • Adult Social Care Funding (England) • Health and Social Care Integration • Social care: Government reviews and policy proposals for paying for care since 1997 (England) • Social care: care home market – structure, issues, and cross- subsidisation (England) • Social care: Announcements delaying the introduction of funding reforms (including the cap) (England) • Social care: how the postponed changes to paying for care, including the cap, would have worked (England) • Social care: Recent changes to the CQC's regulation of adult residential care (care homes) • Four Seasons Health Care Group – financial difficulties and safeguards for clients

Version control (from version 4.0 onwards) 4.0 21/2/20 Title changed from “Social care: the Conservative Party's 2017 General Election pledges on how individuals pay for care (England)” and paper rewritten to provide summary of key developments under the Conservative Government since 2015.

About the Library The House of Commons Library research service provides MPs and their staff with the impartial briefing and evidence base they need to do their work in scrutinising Government, proposing legislation, and supporting constituents. As well as providing MPs with a confidential service we publish open briefing papers, which are available on the Parliament website. Every effort is made to ensure that the information contained in these publicly available research briefings is correct at the time of publication. Readers should be aware however that briefings are not necessarily updated or otherwise amended to reflect subsequent changes. If you have any comments on our briefings please email [email protected]. Authors are available to discuss the content of this briefing only with Members and their staff. If you have any general questions about the work of the House of Commons you can email [email protected]. Disclaimer This information is provided to Members of Parliament in support of their parliamentary duties. It is a general briefing only and should not be relied on as a substitute for specific advice. The House of Commons or the author(s) shall not be liable for any errors or omissions, or for any loss or damage of any kind arising from its use, and may remove, vary or amend any information at any time without prior notice. The House of Commons accepts no responsibility for any references or links to, BRIEFING PAPER or the content of, information maintained by third parties. This information is Number 8001 provided subject to the conditions of the Open Parliament Licence. 21 February 2020