The silence is deafening – what the Tory leadership candidates are not saying about social care

Published by Professional Social Work magazine, 10 August 2022

Talking about social care has never been viewed as a vote winner in elections, let alone a Conservative Party leadership contest.

Which makes it a bit challenging assessing which of the two candidates will prove a better Prime Minister for social workers and social care.

Last month SNP MSP Karen Adam described the silence as “deafening” during the Conservative Party leadership race – she was speaking in relation to poverty, but other policy areas are equally muted.

Into this vacuum, sector leaders, including BASW, have stepped, attempting to make their voices heard, spelling out what they believe needs to be at the top of the new PM’s in-tray.

We take a look at what's being called for – and how the two candidates may respond….

Social care

A growing chorus of voices from the sector is urging the leadership candidates to visit the frontline to see the social care crisis for themselves.

Mike Padgham, chair of the Independent Care Group (ICG), has written a letter to Rishi Sunak and Liz Truss, calling on them to come clean over their plans for social care.

He says in the letter: “I would like to invite you to visit a frontline social care provider to see for yourself the crisis facing the care of our oldest and most vulnerable citizens.

“We have been warning for more than 30 years that social care was not being funded properly to provide a good, sustainable service for people who need that care every day to help them live a full life.

“Now a beleaguered social care sector finds itself facing a massive staffing shortage and huge increases in costs, including fuel and utility prices.”

Padgham wants more of the Health and Social Care Levy, introduced by Sunak in April, and funded by a 1.25 per cent increase in National Insurance, to go to social care.

And Mencap chief executive Edel Harris has urged the candidates to “commit to the necessary funding” to ease pressures.

Liz Truss has promised more money for social care to ease bed blocking, but in almost the same breath, announced plans to scrap the hike in National Insurance that was supposed to act as a precursor to the Health and Social Care Levy.

A recent poll of Conservative voters found that 37 per cent do not think that either candidate will fix the social care crisis.

And there are concerns among MPs that the cash originally promised to social care in the levy – which only amounted to a seventh of the £36 billion raised over the next three years - "wouldn't touch the sides" in terms of fixing a "ravaged" sector.

Truss claims there is already money available for social care, while Sunak has stuck to his decision to keep the levy, which he introduced as Chancellor.

It is not clear how Liz Truss will find the money if she goes ahead with reversing the rise in NI which the Institute for Fiscal Studies (IFS) predicts would cost £13 billion per year.

Cost of living

The cost-of-living crisis will be the biggest immediate challenge facing the new PM, particularly with average household fuel bills expected to rise to £3,582 in October and an eye-watering £4,266 in January.

In response to this, Truss pledged an emergency budget and tax cuts which she claims will prevent the UK plunging into recession.

She would also suspend the green levy on energy bills which pays for social and green projects. But with the social impacts of climate change increasingly being recognised in social work, will this sit well with the profession?

Sunak recently pledged to cut energy bills for 16 million vulnerable people and reduce the October energy price cap rise with up to £10 billion of extra support.

He has also pledged to scrap the five per cent VAT on household energy bills for one year if the price cap on bills rises above £3,000 for the typical household.

Sunak wants to address inflation first to keep interest rates down, claiming a rise in this will have a devastating impact on households and the economy. 

But commentators including financial journalist Martin Lewis have criticised both candidates for failing to recognise the enormity of the energy price rises heading our way. A coalition of 70 charities has written to both leadership candidates to press home the scale of the “national emergency” which they claim will result in a "catastrophe on a vast scale" this winter without action.

So far neither candidate has produced a plan to inspire confidence that the most vulnerable will be adequately protected.

Poverty and inequality

Commentators and sector leaders alike have been quick to point out that tax cuts don’t help those most in need.

In a letter to the two candidates, BASW’s chief executive Ruth Allen said: “Tax cuts will not help those who are on such low incomes that they do not pay tax in the first instance…

“The next Prime Minister should make a commitment to lifting people out of poverty, which will not be achieved by further penalising those on low incomes who are already struggling.”

But is tackling poverty a priority for either candidate?

Both come from privileged backgrounds, though Truss makes a big deal of flagging up her comprehensive school education against Sunak’s private schooling.

Sunak's wife Akshata Murthy is the daughter of billionaire Indian businessman Narayana Murthy but makes a point of highlighting how he worked as a waiter in an Indian restaurant as a student and is the son of immigrant parents.

Truss says children at the state school she attended in Leeds were "let down" by the education system. Might this suggest a stronger emphasis on education as a vehicle for promoting equality?

The Nuffield Foundation this week published a report showing educational disadvantage has barely changed in 20 years and has been made worse by the pandemic.

It’s director of education Josh Hillman says it is “crucial that any reform of the system considers all phases of education and that it addresses the socio-economic factors that lead to disadvantage.”

Meanwhile Truss has said she would lift the ban on new grammar schools, which some might say reveals a focus on middle class families rather than the most disadvantaged. Sunak won’t be drawn on grammar schools thus far.

Children and families

Last week five children’s charities including the NSPCC and Barnardo’s called on the next PM to radically reform children’s social care, maintaining the current system is “not working”.

In a letter to the two candidates, the charities say the care system has let children down badly. Statistics show more children are coming into care, blamed on increased pressure on families and a lack of investment in early intervention and support services.

A review of children’s social care in England led by former frontline chief executive Josh MacAlister published its recommendations for a more “family help” focused system. A review is also underway in Northern Ireland led by social work academic and former social services director Ray Jones.

In the BASW letter to Truss and Sunak, Ruth Allen says cuts to local authority budgets have forced councils to prioritise statutory services at the expense of prevention and early intervention work. She writes: "We are also aware that some statutory services are being deprioritised, which is leading to soaring demand for later stage crisis services. These cost a fortune in money, misery and compounded needs in the long term."

Conservative policy in recent years has seen investment in family hubs in local neighbourhoods. It's likely this rollout will continue under both candidates. But will either be prepared to make – and pay – for transformational reform, including addressing the recruitment crisis in children's services? England’s Independent Review of Children’s Social Care calls for £2.6 billion to be spent on reforming the system over the next five years. But in the face of the distraction of the leadership contest and the ongoing cost-of-living crisis there's a real risk of this getting kicked into the long grass.

Mental health

Very little, if anything at all, has been said about mental health during the leadership campaign.

Claire Murdoch, NHS England national director for mental health, has warned the “silence is deafening” from the Tory leadership candidates, especially on the treatment backlog in the NHS.

Charity Rethink Mental Illness has written to Truss and Sunak asking them to commit to the reforms to the Mental Health Act - published in a white paper last year - and support and fund the NHS Long Term Plan.

And former prize fighter and mental health campaigner Frank Bruno has called the candidates “out of order” for not addressing the issue more, saying: "I've not heard much said by Rishi Sunak or Liz Truss on it.”

Disability

The Disability News Service (DNS) says neither candidate has responded to questions on how they would improve the lives of disabled people if they became PM.

According to the DNS, they have failed to say what they would do to end the crisis in adult social care - a crisis leaving thousands of disabled people in debt because they can't afford to pay council care charges. Allen's letter highlights the greater and more complex needs of an ageing population, warning funding is needed to "avert a developing adult social care crisis".

Answers from the candidates have also not been forthcoming on accessible housing, deaths linked to the alleged actions of the DWP, or what each candidate considers to be the greatest disability-related achievement of 12 years of Conservative government.

Privatisation

Sunak has recently said that “radical thinking” in public services would cut waiting lists and reduce the size of the state. “We have to think boldly and differently about public services across the board."

But what does this mean? Bold and radical thinking within a Conservative government is all too often linked to privatisation and outsourcing, something that rings alarm bells among social justice campaigners who equate this with reduced regulation to make services more attractive for a private sector takeover. Reduced regulation in public services runs the risk of reduced rights.

Those against privatisation of public services may also see concern in Liz Truss’ membership of the hard-right think tank 1828 which states as its mission “to make the case for free markets and limited government”. A manifesto by the group’s founders published in 2019 called for the NHS to be abolished and replaced with a “social health insurance system”.

Conclusion

Many in the social work profession will see the Tory leadership contest as a choice between two evils. Both candidates are members of a political party that has presided over a decade of austerity cuts which saw funding to local authorities decimated and services slashed.

Furthermore, the spectre of privatisation is ever-present within Tory policy.

Truss’s claims about her background could be seen as an attempt to root her more in the real world, while Sunak is staking his bid on retaining the rise in NI which will inject funding into social care.

‘Levelling up’ has so far proved not much more than a Tory buzzword. Perhaps the most telling indicator in the coming weeks will be which candidate can show they have truly grasped the enormity of the cost-of-living crisis that is only going to get worse...