No Integration Without Parity of Esteem

Karolina Gerlich, CEO, The Care Workers Charity

With the recent and ongoing conversations around social care reform, the sector has been in the spotlight- a particular focus has been on the proposed integration of the health and social care sectors. But while this is viewed rather as a ‘silver bullet’ for the challenges faced by social care- I believe that there should not be (nor can there be) implementation of integration policy without first achieving parity of esteem between the health and social care sectors.

Whilst I welcome the efforts of the Government to improve health and care via the recently proposed Health and Social Care Bill I am concerned that the Bill is very clearly driven by the needs of the NHS and healthcare system. As it stands, the content of the proposed document prioritises the NHS and healthcare services at the expense of social care- which is only seen as important in a supporting role for the NHS. I feel that this sets a precedent whereby social care is not recognised in its own right, and also risks medicalising social care due to the dominance of healthcare services in the relationship. Joined up working could represent an opportunity to increase service quality across health and social care sectors- but this will only work if both are on an equal footing- an ambition which is a long way from being realised.

Parity of esteem between the two sectors has long been an issue for social care, with its workforce lacking the respect, recognition and fair treatment that its healthcare counterparts have enjoyed. This was demonstrated most recently in the Prime Minister’s Statement on Social Care, where hopes for a real increase to sector funding were dashed as it became apparent that social care would receive only a small portion of the total funding, with the immediate priority cited as getting the NHS back on its feet- and so the sector continues to be sidelined. To add insult to injury, the Prime Minister greatly praised the role and work of the “amazing” NHS and healthcare staff during the pandemic, but appeared to have forgotten the social care sector and its workforce entirely- who, as we well know, have given their all with very little recognition, respect and appreciation received in return.

Any moves to facilitate real reform in social care will not be possible until the social care sector, the voices of its leaders, its workforce and those who draw on its services are heard- and more importantly, that it is these voices that shape the policy and decision making process at all levels of government. Most of all, it is vitally important that we achieve parity of esteem between the social care and healthcare sectors. Following his initial Social Care statement last week, the Prime Minister commented that his was “the party that tackles social care [and] the party of the NHS”- for too long the social care sector and its workforce have been problematised, this must be rectified and equality must be the base on which real change is built.


Edel Harris





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