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| Jeremy Hunt has raised the stakes in how history will judge him | Jeremy Hunt has raised the stakes in how history will judge him |
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| So now it is the Department of Health and Social Care. There is no doubt that the new name is a much-needed symbolic boost for the battered cause of adult social care in England, but it is less clear how else Theresa May’s reshuffle – and Jeremy Hunt’s reported refusal to move from the department he continues to lead – will change things. Although we await further detail on how Hunt plans to address the social care challenge with new vigour, and what, if any, new powers he may have to do so, the early judgment must be: not a lot. | So now it is the Department of Health and Social Care. There is no doubt that the new name is a much-needed symbolic boost for the battered cause of adult social care in England, but it is less clear how else Theresa May’s reshuffle – and Jeremy Hunt’s reported refusal to move from the department he continues to lead – will change things. Although we await further detail on how Hunt plans to address the social care challenge with new vigour, and what, if any, new powers he may have to do so, the early judgment must be: not a lot. |
| One thing that can be said is that Hunt has consciously raised the stakes in how history will judge him. Barring any unforeseen impediment, not only will he oversee celebrations for the NHS’s 70th year in July as the longest serving secretary of state responsible for health, overtaking Nye Bevan next month and Norman Fowler in June, but he has made a very public declaration of intent to deliver the reform of social care that has eluded so many politicians before him. | One thing that can be said is that Hunt has consciously raised the stakes in how history will judge him. Barring any unforeseen impediment, not only will he oversee celebrations for the NHS’s 70th year in July as the longest serving secretary of state responsible for health, overtaking Nye Bevan next month and Norman Fowler in June, but he has made a very public declaration of intent to deliver the reform of social care that has eluded so many politicians before him. |
| Contrary to initial and excitable reports, Hunt did not ask May to add social care to his brief. He already had it. Policy responsibility for adult social care has always rested with the health department – even when it was, until 1988, the Department of Health and Social Security – although health has conspicuously played first fiddle. The fact that so many observers seem to have been unaware of this shows just how low social care’s profile has been. | Contrary to initial and excitable reports, Hunt did not ask May to add social care to his brief. He already had it. Policy responsibility for adult social care has always rested with the health department – even when it was, until 1988, the Department of Health and Social Security – although health has conspicuously played first fiddle. The fact that so many observers seem to have been unaware of this shows just how low social care’s profile has been. |
| However, funding for social care has largely been overseen by the department responsible for local councils which administer care and support, newly named the Ministry of Housing, Communities and Local Government. There is no sign of that changing; indeed, the introduction in 2015 of an earmarked precept or levy for social care, now worth up to 3% on council tax, seems to have further cemented that arrangement. | However, funding for social care has largely been overseen by the department responsible for local councils which administer care and support, newly named the Ministry of Housing, Communities and Local Government. There is no sign of that changing; indeed, the introduction in 2015 of an earmarked precept or levy for social care, now worth up to 3% on council tax, seems to have further cemented that arrangement. |
| The much-anticipated green paper on social care for older people is set to be published by summer 2018 – although, having been promised before last year’s general election, there were hopes the paper would appear much sooner. | |
| It was also hoped the paper would address needs across the entire adult social care sector. Instead, the paper will be limited to the government’s plans for improving care and support for older people and tackling the challenges presented by an ageing population. | |
| There will be a ‘parallel work stream on working age disabled adults’, but some are concerned this report will focus on getting more disabled people into work. | There will be a ‘parallel work stream on working age disabled adults’, but some are concerned this report will focus on getting more disabled people into work. |
| The government has invited a number of people to advise on the paper, including Paul Burstow, chair of the Social Care Institute for Excellence; and Caroline Abrahams, charity director of Age UK. However, no user or care worker representatives have been invited. | |
| During a cabinet reshuffle in early January, Jeremy Hunt became secretary of state for health and social care. Despite already having social care in his mandate, the change gave Hunt lead responsibility for the green paper. | |
| The proposals set out in the paper will build on the additional £2bn the government has provided to meet social care needs, reduce pressures on NHS services and stabilise the social care provider market over the next three years. Once published, the paper will be subject to a full public consultation. | The proposals set out in the paper will build on the additional £2bn the government has provided to meet social care needs, reduce pressures on NHS services and stabilise the social care provider market over the next three years. Once published, the paper will be subject to a full public consultation. |
| What Hunt has gained is lead responsibility for the social care green paper, due this summer, which will set out the government’s consultative proposals for reforming care and support for older people in England, principally the controversial balance of state funding and individual liability. | What Hunt has gained is lead responsibility for the social care green paper, due this summer, which will set out the government’s consultative proposals for reforming care and support for older people in England, principally the controversial balance of state funding and individual liability. |
| That responsibility had been with the Cabinet Office, which was approaching the task on a cross-government basis. As Damian Green, the former Cabinet Office minister and first secretary of state, said when he announced the green paper in November: “To achieve reform where previous attempts have failed, we must look more broadly than social care services alone. Our vision for care must also incorporate the wider networks of support and services which help older people to live independently, including the crucial role of housing and the interaction with other public services.” | That responsibility had been with the Cabinet Office, which was approaching the task on a cross-government basis. As Damian Green, the former Cabinet Office minister and first secretary of state, said when he announced the green paper in November: “To achieve reform where previous attempts have failed, we must look more broadly than social care services alone. Our vision for care must also incorporate the wider networks of support and services which help older people to live independently, including the crucial role of housing and the interaction with other public services.” |
| With the green paper now being led by Hunt at the DHSC, the danger is that such a rightly broad perspective will be lost and the focus will become a narrow one of individual cost liability and how social care can help the NHS by moving people more quickly out of hospital. | With the green paper now being led by Hunt at the DHSC, the danger is that such a rightly broad perspective will be lost and the focus will become a narrow one of individual cost liability and how social care can help the NHS by moving people more quickly out of hospital. |
| More positively, the green paper will now sit better alongside the “parallel programme of work” being undertaken by the health department on care and support for younger people with disabilities. Campaigners will surely push hard for the two programmes to come together, and Hunt will have his work cut out to justify a continued distinction. We know he enjoys dancing the lambada; now we shall see how good he is on the head of a pin. | More positively, the green paper will now sit better alongside the “parallel programme of work” being undertaken by the health department on care and support for younger people with disabilities. Campaigners will surely push hard for the two programmes to come together, and Hunt will have his work cut out to justify a continued distinction. We know he enjoys dancing the lambada; now we shall see how good he is on the head of a pin. |
| David Brindle is the Guardian’s public services editor | David Brindle is the Guardian’s public services editor |
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