The Prime Minister has set out plans to tackle the COVID backlogs, reform adult social care, and bring the health and social care system closer together on a long term, sustainable footing.
£36 billion will be invested in the health and care system over the next three years, to ensure it has the long term resource it needs. Patients will benefit from the biggest catch-up programme in the NHS’s history.
Social care will be reformed, ending "unpredictable and catastrophic care costs" faced by thousands, and making the system "fairer for all", according to the Government. From April 2022, a new, UK-wide 1.25 per cent Health and Social Care Levy will be introduced, ring-fenced for health and social care. This will be based on National Insurance contributions (NICs) and from 2023 will be legislatively separate.
To ensure everyone contributes fairly, all working adults, including those over the state pension age, will pay the levy and the rates of dividend tax will also increase by 1.25% to help fund this package. Every individual will contribute according to their means. Those who earn more pay more, with the highest earning 14 per cent of people paying around half the revenues.
Employers will be asked to contribute so the costs are more widely shared. This will raise around £12 billion in extra funding per year, to be invested in frontline health and social care across the UK over the next three years.
Boris Johnson commented: "You can’t fix the COVID backlogs without giving the NHS the money it needs. You can’t fix the NHS without fixing social care, you can’t fix social care without removing the fear of losing everything to pay for it, and you can’t fix health and social care without long-term reform. The plan I am setting out today will fix all of these problems together."
Responding to the announcement, Anita Charlesworth, Health Foundation Director of Research and the REAL Centre, said: "The introduction of a cap on social care costs is, at long last, a positive and bold step forward. It will provide people with greater certainty about the future costs they need to plan for and help reduce the care cost lottery. But the funding announced falls well short of what is needed to stabilise the current system and deliver the comprehensive reform that is so desperately needed. The proposals are less generous than those legislated for in the 2014 Care Act.
"With the cap set at £86k, most people will be protected from catastrophic care costs, but those with modest assets and high care needs will still risk losing a high proportion of their wealth in future. For example, an individual whose house is valued at £125k still risks losing almost half of their housing wealth whereas a cap set at £50k would have enabled them to retain two thirds. By comparison, a person with a house valued at £500k risks losing less than a fifth of their housing wealth.
"And a cap alone will not be enough to deliver the prime minister’s promise to 'fix social care once and for all. The announcement does little to help the third of care users aged under 65 who rely on the quality of the publicly funded system. The Government has parked decisions on wider funding and reform – much now rests on the forthcoming autumn spending review. In addition to the cost of the cap, further funding increases, rising to an extra £9.3bn in 2024/25, will be needed to support the growing number of people going without the care they need, raise care quality, stabilise the provider market and improve the pay and conditions of those working in the sector. Without this, social care will continue to fail people who need it.
"The government has announced significant new funding for the NHS, including £10bn specifically to tackle the elective care backlog. While this is a huge amount, the scale of the care backlog means that even with this funding, the waiting list will almost certainly be longer at the end of this parliament than it is now. To meet the 18-week standard by 2024/25 would have required closer to £17bn over this parliament. But money is far from the only challenge. The extra staff, beds and equipment needed to treat so many more patients in the coming years are likely to be the biggest hurdles to recovery. Given the lead times for training staff, targeted investment in the workforce is needed now. Otherwise, waiting lists are likely to remain very high for many years to come.
"Overall, the funding announced for the NHS is not sufficient for an ambitious recovery programme. If COVID-19 continues to require enhanced infection control beyond this year, there is a real risk that the NHS will be forced to make very hard trade-offs between tackling the elective care backlog and delivering on the planned investment to improve primary, community and mental health services, while delivering services that are safe for patients and staff."
