Spring Budget 2021: Social care, gender and Covid-19

Key Points

• The need to reform the social care sector is long overdue. Decades of cuts, deregulation and privatisation have left the sector in crisis and ill-equipped to respond adequately to the Covid-19 pandemic. In addition, throughout the Covid-19 pandemic, the social care sector has been treated as the ‘poor relation’ to the NHS, with less access to PPE, testing and resourcing.
• As a result, those in need of care and those providing care – the majority of whom are women – have been disproportionately impacted by Covid-19. At the peak of deaths in the first wave (last week of April 2020), there were 2,769 deaths involving Covid-19 in care homes in the UK compared with 938 in hospital. ¹
• Care workers are twice as likely to die from Covid-19 as non-key workers, with Black, Asian and ethnic minority (BAME) workers at a particularly increased risk. ² Care workers are also more likely to die from Covid-19 than their NHS counterparts.
• The origins of the crisis in care predate the Covid-19 pandemic:
  •  Deregulation and privatisation have led to a to a care sector that is dominated by private providers focused on increased financial yields and cost minimisation.
  • Funding has been inadequate to address rising needs for decades, and there are increasing geographical inequalities in the social care system.  Although government grants to local authorities halved since 2010, responsibility for resourcing care remains with local authorities. Income from local taxes, including the increases announced in the 2020 Spending Review, have been insufficient to compensate for these cuts.
  • Staff shortages are high and likely to worsen. Prior to the pandemic, in a workforce of 1.2 million there were 122,000 social care staff vacancies ³ Nearly a fifth of the current workforce were not born in the UK. The post-Brexit immigration system excludes thousands of potential care workers because they do not meet the pay and qualification thresholds.
  • The numbers of unpaid carers have grown steadily over the last two decades and particularly during the Covid-19 pandemic. Since the onset of Covid-19 the numbers of unpaid carers have increased by an estimated 4.5 million to over 13.6 million in total and support needs have intensified. ⁴
• The crisis in social care exacerbates gender inequality since women are more likely than men to work in care, be in receipt of care in old age and to take on responsibility for unpaid care for elderly, disabled and/or vulnerable adults of working age.
• WBG calls for a new settlement for social care that provides a stable, sustainable funding base to ensure that rising care needs are met now and into the future. This should take the form of a Universal Care Service that provides locally based residential, domiciliary, and other forms of care, free at the point of delivery and on an equal footing with the NHS.

Investment in care is needed not only to transform our broken social care system, but is also a good way to stimulate employment, reduce both the gender employment and pay gaps and counter the inevitable economic recession as the UK comes out of lockdown

[1] ONS (2020) Deaths involving COVID-19 in the UK, March to April 2020. This is much lower than William, L. and Buisson. (2020) 34,000 older care home residents in England will have died from Covid-19 and collateral damage by the end of June, it is projected. Care markets.  (https://bit.ly/3fsFqVp)

[2] ONS (2020) Coronavirus (COVID-19) related deaths by occupation, England and Wales: deaths registered between 9 March and 25 May 2020 (https://bit.ly/3kPZHp0)

[3] Skills for Social Care (2019) The state of social care workforce 2019 cited in House of Commons Library (2020) The health and social care workforce gap (https://bit.ly/3qQBSBb)

[4] UK Carers (2020) Forgotten families in the coronavirus outbreak (https://bit.ly/3fk4kGQ)

View and download full briefing here.