England’s most senior church leaders want tax rises to fund a new NHS-style universal social care system that could cost an extra £15bn a year.
In a challenge to the government to overhaul support for 1 million elderly and disabled people, the archbishops of Canterbury and York have called for a “national care covenant” with a stronger role for the state and citizens delivering more care.
A 20-month inquiry ordered by Justin Welby and Stephen Cottrell has concluded inaction to fix what Welby described as “our broken social care system” would be “a collective sin”. It said wealth and income taxes should share the cost between individuals, households and businesses.
The bold intervention comes four months after Rishi Sunak shelved plans to raise taxes to increase social care funding and amid a deepening crisis blamed for NHS blockages that are costing lives. More than half a million people are waiting for care or assessments.
The review attacks the “very limited proposals put forward by recent governments” and says they are being outpaced by improvements in Germany and Japan, and plans in Wales and Scotland for a national care service.
Social care must become a “universal entitlement on a par with the NHS” rather than rationed by the “meanest of means tests”, the review concluded. It advocates paid leave for 5 million unpaid carers, help for people with more moderate needs and a system that enables people “to live the best lives they can”, not just meet basic requirements.
The archbishops have not put a cost on the changes, but the review’s co-author, Rt Revd James Newcome, the bishop of Carlisle, said it would be “on track” with proposals from the House of Lords social care committee. It said £8bn a year is needed to restore funding to 2010 levels and a further £7bn for free personal care by 2026.
The review also suggests the £69.70 weekly carers allowance must be “urgently reviewed”, there should be new community funds to support citizens to care for neighbours in their own homes, and care recipients should have a greater say over how they spend their care budget.
“It will cost money, but currently those costs fall to families; they fall to the economy with people not working who are caring; they fall to the NHS in terms of waste,” said the co-chair Dr Anna Dixon.
But the review also seeks to cast social care reform as a moral issue. Dixon said the commission started by thinking about “love, trust, mutuality – perhaps not words that are normally used in policy discourse around social care”.
“The power of valuing those outwardly powerless is a test of a society that acts well,” Welby and Cottrell said. No one should be “treated as surplus and ‘just a burden’ because of their age or ability.”
Last week the Guardian exposed the owner of Runwood Homes, Gordon Sanders, who made at least £21m in five years despite inspectors finding multiple rule breaches in his firm’s homes.
Speaking generally about care homes, the bishop of Carlisle said: “When they’re raising millions and millions and making that money out of the hard work of people who are being underpaid … it doesn’t take a lot of imagination for people to come to their own conclusions about the morality of that.”
In November the government pledged up to £7.5bn in new money to support care services over two years, short of the £7bn a year hike the chancellor, Jeremy Hunt, said in 2020 was needed just to meet current needs. He made that assessment before returning to cabinet when he chaired the Commons health and social care select committee. Pressures are only expected to rise with the number of people living with dementia forecast to grow from 900,000 to 1.6 million by 2040.
A spokesperson for the Department of Health and Social Care said it worked with “a range of stakeholders on how best to improve adult social care”. It claimed it was making progress on boosting workforce capacity and improving oversight of the system and in spring it will publish a two-year reform plan.
Liz Kendall, the shadow care minister, said the archbishops’ proposals were “refreshingly bold” and were “in line with Labour’s aim of returning power to those who matter most – the people who rely on care and their families”.