Health and social care must both be public

Submitted by AWL on 5 August, 2020 - 8:09 Author: Editorial
Care strikers

Watch the video of the article on this page

The Guardian reports a Department for Health and Social Care spokesperson saying there is “no foundation” to claims that the government plans to bring social care under the umbrella of the NHS. But rumours are widespread enough that the denial comes at the end of a longish article on the claims. The Guardian has since covered the possibility fairly extensively, as have other media outlets.

We want social care made a free public service, publicly-owned and provided, with its staff on secure public-sector pay and conditions.

Health and care campaigners are divided on the general issue of NHS/care integration. Last year’s Labour conference voted both that “our publicly-owned NHS needs to be fully integrated with Social Care systems which should all… be public”; and that “consequences of marrying social care to the NHS include medicalisation, isolation, indignity, maltreatment; bringing social care under a struggling NHS umbrella is not the answer.”

Most campaigners are to one degree or another sceptical, at least on the basis of what it would mean when social care is extensively privatised, radically fragmented and in a partial state of collapse. “We have to say that the state of social care, its fragmentation and privatisation, means that at present there is nothing acceptable for the NHS to integrate with”, as Keep Our NHS Public’s John Lister put it at a recent conference on social care.

Whatever the exact relation in future between a publicly-owned social care service and the NHS – obviously it would have to be fairly close – just pushing the existing privatised social care network under the NHS umbrella would mean more privatisation within the NHS, not more public care provision or improved standards for service-users and workers. There are also debates about national vs local planning and control, and the sector's relationship to councils as well as the health service.

Local government leaders don't want social care taken out of their remit. “Shifting responsibility for care is not the answer and will fail to address the fundamental issues that have pushed the system to breaking point”, said Local Government Association chair Jamie Jamieson.

But the LGA is not providing answers either. Neither are the Labour Party and the unions.

All the policy passed at Labour conference last year was very clear that social care must be a comprehensively public system. Jeremy Corbyn’s Labour leadership was hesitant about arguing for that; Keir Starmer’s simply refuses.

We need more debate in the labour movement about the relationship between social care and the NHS, going beyond undefined buzzwords like “integration”. But no relationship will work well unless on the basis of the kind of policy Labour Party conference has called for – comprehensive public ownership of care.

• Add your name to this statement from the Safe and Equal campaign
• Policy passed at Labour conference 2019 (the "anti-integration" motion is much more detailed; the "pro-integration" statement is one sentence in a motion on the NHS)
• Briefing on social care and the case for public ownership

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