What’s in a name?

This week has seen the May re-shuffle, nothing too shocking in all of that. For us I guess the most interesting news was that Jeremy Hunt had had two very important words added to his job title – Social Care. So he is now the Minister for Health AND Social Care, finally some recognition of the importance of the sector?

The inference of course is that it is viewed by the Government to be as critical to constituents as Health, the cynic in me is asking ‘really?’ After all what’s in a name?

What it all means in practice and the impact it makes will remain to be seen.

Commenting on this and the upcoming Green paper, David Brindle, Public Services Editor from The Guardian, has this to say:

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.

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.

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.”

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.

This article was originally published in the Guardian

Wishing you a happy and successful 2018!
Lisa Lenton
ARC England Director