Social care: PM to unveil overhaul of sector in England

Boris Johnson will vow to end “catastrophic costs” for social care users in England, when he sets out long-awaited reform proposals later.

The prime minister will announce the plans to MPs, alongside long-term funding arrangements to help the NHS respond to the Covid pandemic.

He is expected to breach election promises and raise National Insurance by about 1.25% to cover the costs.

Some Tory MPs and Labour have said this is the wrong way to raise the money.

The PM is due to present his plans to the cabinet on Tuesday morning, before setting out the details in a statement to the Commons.

He will then join Chancellor Rishi Sunak and Health Secretary Sajid Javid for a press conference later in the day.

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“His broken promises on tax rises cannot be followed by more broken promises for the NHS,”

On Monday an extra £5.4bn over the next six months was announced to help the NHS in England tackle backlogs worsened by the pandemic.

Mr Johnson will tell MPs the NHS has been “put under enormous strain by the pandemic” and cannot be expected “to recover alone”.

He is expected to say the government will not “duck the tough decisions needed” to help the service and fix England’s “broken” social care system.

And he will promise to “end the injustice of catastrophic costs” for those requiring long-term care.

However, reports he will raise National Insurance, a tax paid by workers and employers, to cover costs has sparked a backlash from Conservatives.


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What can we expect?


Analysis box by Laura Kuenssberg, political editor


The government is expected to announce an increase in National Insurance, likely of 1.25%, to raise billions of pounds to pay for helping the NHS catch up with lost time and treatment after the pandemic, and to help improve and pay for social care in England.

I’m told the cash raised – potentially more than £12 billion – will be ring-fenced somehow, targeted initially at the health service itself then will switch to social care after three years.

Expect also promises of changes to how the system works, including limiting the amount that families have to pay for care if need it.

Read more from Laura


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The party made a manifesto commitment not to raise National Insurance (NI), income tax or VAT during the 2019 general election.

It is widely accepted that major changes are needed to the social care system, which helps older and disabled people with day-to-day tasks such as washing, dressing, eating and medication.

While some Tories accept tax rises are needed, they say a hike in NI – which would not be paid by pensioners – is the wrong way to fund reforms.

According to think tank the King’s Fund, local councils received 1.9m requests for support in 2019-20, with 560,000 from working age adults and 1.4m from older people.

One cabinet minister has told the BBC a National Insurance hike was “the wrong thing to do, and the wrong way to go about it”.

Tory former chancellors Lord Hammond, Lord Clarke and Lord Lamont have all criticised the plan, while former Tory PM Sir John Major has called it “regressive”.


Carer in woman's home

image sourceGetty Images

Mr Johnson has been under pressure to spell out his plans to overhaul the social care system, after announcing after taking office in 2019 that he had a “clear plan” to fix the “crisis” facing the sector.

Reports have suggested that the overhaul will place a limit – or “cap” – on the lifetime contributions made by individuals, with the taxpayer funding costs on top of this.

This would be a version of a plan suggested by Sir Andrew Dilnot, the former UK statistics chief, who advocated a £35,000 lifetime cap in 2011.

They were put into law in 2014 under the Conservative-Liberal Democrat coalition, but delayed and then eventually ditched under David Cameron.

His successor, Theresa May, later suggested and then abandoned a form of the proposals in 2017.

‘Broken promises’

Labour says it supports extra funding for the NHS and social care, but National Insurance rises would hit young people and businesses and it will not support the move.

Shadow health secretary Jonathan Ashworth said a “Tory decade of neglect” had left the care sector and the NHS unprepared for the pandemic, and a long-term overhaul was “long overdue”.

He added that the prime minister needed to detail a plan to bring down NHS waiting lists – which have hit more than five million in England – and support healthcare workers.

“His broken promises on tax rises cannot be followed by more broken promises for the NHS,” he added.

Separate UK systems

The social care system is devolved across the four UK nations, meaning governments need to develop separate solutions.

In England, social care is generally not provided for free. Typically, only those with savings and assets worth less than £23,250 can get help from their council.

There is no overall limit on costs, meaning thousands every year end up selling their homes to pay.

Personal care, such as help with washing and dressing, is free in Scotland for those assessed by their local authority as needing it. Those in a home still have to contribute towards accommodation costs.

Some care costs are capped in Wales, and home care is free for the over-75s in Northern Ireland.

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