Gavin Edwards, Head of Care at trade union UNISON, explores the concept of a National Care Service and the opportunities and challenges it presents.
A reboot of social care is long overdue. There must be a move away from the fragmented, underfunded, profit-focused provision that’s caused the current workforce crisis.
Change cannot happen overnight – the overhaul required is too great for swift solutions. But it’s in no one’s interests for the commission on adult social care led by Baroness Casey to take years to report. This government must show it is getting to grips with reform where previous administrations have failed.
As the largest union in the care sector, UNISON is leading the campaign to create a nationally recognised institution, the national care service (NCS)—one that responds to the needs of older and disabled people, improving and enriching their lives by providing world-class support.
Change cannot happen overnight – the overhaul required is too great for swift solutions. But it’s in no one’s interests for the commission on adult social care led by Baroness Casey to take years to report. This government must show it is getting to grips with reform where previous administrations have failed.
A national service would boost workforce retention, morale, and professional development. Pay is too low, despite care work being difficult and skilled, with huge responsibilities. Some care workers earn even less than the minimum wage because travel time between visits isn’t paid or they receive inadequate payment for overnight shifts. That’s why the first step in transforming the sector must be a fair pay agreement. This process will, for the first time, see unions and employers negotiating at a national level a new rate to help solve the recruitment and retention crisis. An annual fair pay agreement, enforced by a new fair work agency, will help boost staff terms and conditions that have held the sector back for decades.
Care employers like Dimensions, Four Seasons, and Marie Curie are among those already benefitting from having an independent union to represent their workers. The hope is that other employers will join them by negotiating similar recognition agreements with UNISON to represent their workforces. Some might argue it’ll cost too much to invest in social care, but the country can’t afford not to. Care has suffered from years of underinvestment, leaving hundreds of thousands of elderly and disabled people without the support they need and an NHS on its knees. Spending on care would bring huge benefits to society and the wider economy. A national service would also drive innovation because there would be national oversight to spread best practices that’s currently non-existent.
The right leadership is also needed to ensure effective integration across different care services under a national framework. Workforce planning, education, and employment conditions must be closely aligned. This is precisely the approach recommended in a blueprint for a national service published last year by the Fabian Society and UNISON. National standards, a ‘home first’ approach, fair resourcing, and a shift away from profit-making—all recommended by the report—would give councils the agency they need to provide and commission the care families need. Local flexibility in delivering care would be enhanced by a national service, in stark contrast to the current ‘flexibility’, where a multitude of providers compete over price, driving down service quality and care worker pay. This woeful system has limited access to care for many people who desperately need it, leaving their families coping as best they can.
Social care must no longer be the forgotten frontline. It’s an essential service in its own right, and if it doesn’t function properly, neither does the NHS. Failure to invest in care is a failure to invest in the country’s national infrastructure. With an ageing population, society is paying the price, with NHS delays worsening because people can’t be discharged from hospitals into care or their own homes. For the workforce, the creation of a new national institution, with its own strong values, would be a powerful symbol. It would give them the same sense of purpose health workers feel to be part of the NHS. Care workers would benefit from similar opportunities to learn new skills and progress in their jobs, just as those in healthcare do.
Imagine the sense of pride every care worker could feel in a system that truly values and supports them, with fair pay, job security, proper training, and career development. This vision could—and should—become a reality.
@Unisontheunion
unison.org.uk
