Social care: Boris Johnson to unveil overhaul of sector in England

Boris Johnson has vowed to end "catastrophic costs" for social care users in England ahead of setting out his long-awaited reform proposals.

The prime minister will announce the plans to MPs, alongside money to help the tackle pressures on the NHS caused by the Covid pandemic.

He is expected to breach election promises and raise National Insurance (NI) by about 1.25%.

And the plan has prompted a backlash from some of his own Tory MPs.

Cabinet ministers signed off the proposals at a meeting in No 10 earlier, with the PM's official spokesman saying: "There was strong agreement that this is a long-standing issue, particularly on the social care side, which had been ducked for too long and which needed to be addressed."

Mr Johnson will set out the detail in a statement to the Commons at around 12:30 BST and will join the chancellor and Health Secretary Sajid Javid for a press conference at 16:00.

But tweeting ahead of his appearance, he promised to set out how the government will "support the NHS in the biggest catch-up programme in its history" and announce "a plan for social care to ensure that older people get the best possible care, without the fear or anxiety of catastrophic social care costs".

It is widely accepted that major changes are needed to the social care system, which helps older and working-age people with high care needs to carry out day-to-day tasks, such as washing, dressing, eating and medication.

Labour said it agreed with the need of reform, but criticised the proposed rise in NI, saying it would unfairly target young people and lower earners.

A 1.25% increase to NI would mean someone on a £30,000 salary would pay an additional £255 per year.

But the BBC's political editor Laura Kuenssberg understands that after late night talks, ministers agreed pensioners in work would also have to pay the new "health and social care levy" - despite people being exempt from NI payments after reaching state pension age.

She also said the government might increase the amount of tax paid on income from share dividends to help cover the cost of the new plans.

• Social care plans facing Tory tax backlash

• What are the challenges facing social care?

• Why workers face the bill for care revolution

• What would a National Insurance rise mean for me?

Vaccines Minister Nadhim Zahawi told BBC Breakfast the plans to "deal with a broken social care system" represented "truly historic and ambitious reform".

"One-in-seven people pay £100,000 or more for their social care, so in my view that nettle has to be grasped," he said.

The BBC also understands Chancellor Rishi Sunak is expected to suspend the so-called "triple lock" on pensions - designed so rises in state pensions were not overtaken by the rising cost of living.

The promise made by the Tories is that the state pension increases each year in line with the rising cost of living seen in the Consumer Prices Index (CPI) measure of inflation, increasing average wages, or 2.5%, whichever is highest.

On Monday, an extra £5.4bn over the next six months was announced to help the NHS in England tackle backlogs worsened by the pandemic.

But it is thought Tuesday's announcement will also allocate cash for the long-term, to increase hospital capacity in England to 110% of its current level.

Mr Johnson will tell MPs the NHS has been "put under enormous strain by the pandemic" and cannot be expected "to recover alone".

He is also expected to say the government will not "duck the tough decisions needed" to help the service and fix England's "broken" social care system, again with longer term funding.

But Laura Kuenssberg said the "biggest unknown" would be how much cash social care gets upfront, having been told support will be "phased in", while the NHS would be "main beneficiary of the NI hike for the first three years".

Joyce Pinfield from the National Care Association said the sector was hoping there would be funding for the short and long term.

She told the BBC: "We do need something immediately... because most care providers are at breaking point."

What can we expect?

The government is expected to announce an increase in National Insurance, likely of 1.25 percentage points, to raise billions of pounds to pay for helping the NHS catch up with lost time and treatment after the pandemic, and to help improve and pay for social care in England.

I'm told the cash raised - potentially more than £12 billion - will be ring-fenced somehow, targeted initially at the health service itself then will switch to social care after three years.

Expect also promises of changes to how the system works, including limiting the amount that families have to pay for care if need it.

Read more from Laura

Reports the prime minister will raise NI, a tax paid by workers and employers, to cover costs for the plans has received a terse response from Conservatives.

The party made a manifesto commitment not to raise NI, income tax or VAT during the 2019 general election.

One cabinet minister has told the BBC a National Insurance hike was "the wrong thing to do, and the wrong way to go about it".

Tory former chancellors Lord Hammond, Lord Clarke and Lord Lamont have all criticised the plan, while former Tory PM Sir John Major has called it "regressive".

Just under half of social care expenditure helps working-age adults, according to the King's Fund

Mr Johnson announced after taking office in 2019 that he had a "clear plan" to fix the "crisis" facing the sector.

Reports suggested the overhaul will place a limit - or "cap" - on the lifetime contributions made by individuals, with the taxpayer funding costs on top of this.

This would be a version of a plan suggested by Sir Andrew Dilnot, who advocated a £35,000 lifetime cap in 2011.

It was put into law in 2014 under the Conservative-Liberal Democrat coalition, but delayed and then eventually ditched under David Cameron.

His successor, Theresa May, later suggested and then abandoned a form of the proposals in 2017.

'Overdue'

Former Labour health secretary and Mayor of Greater Manchester Andy Burnham said an NI rise was "flawed" and "unfair" - and suggested ministers should instead ask all pensioners to make a contribution of 10% of their estate, topped up by rises in other taxes, such as capital gains tax.

He told BBC Radio 4's Today programme he wanted "to introduce the NHS principle to social care - everyone would be required to contribute, but everyone would benefit".

Mr Burnham said "for the vast majority of people they'd have peace of mind at a lower cost" and "I don't see how you can do this without asking pensioners to make a contribution".

Meanwhile, Wayne Fitzgerald, Conservative leader of Peterborough City Council, has said he does not think people would mind a tax if they had confidence that it was going to be used for social care.

What are the challenges facing social care?

• Councils in England received 1.9 million requests for social care support during 2019/20, according to the NHS

• Requests have risen by more than 100,000 in five years

• 1.4 million of these were from older people - but 560,000 came from working-age adults

• Despite the rise in demand, total expenditure on adult social care was only £99m more than in 2010/11, with council spending in England about 3% lower than in 2010

• An ageing population also means growing demand - Age UK estimates 1.5 million in England don't get the help they need

• There are no standard fees for social care elements in England - meaning people face a postcode lottery

• People who don't qualify for free care are often charged more, even within the same care homes, with no maximum limit

• There are huge staff shortages - the King's Fund think tank says average wages are lower than some retail staff and cleaners

The social care system is devolved across the four UK nations, meaning governments need to develop separate solutions.

In England, social care is generally not provided for free. Typically, only those with savings and assets worth less than £23,250 can get help from their council and there is no overall limit on costs.

Personal care, such as help with washing and dressing, is free in Scotland for those assessed by their local authority as needing it. Those in a home still have to contribute towards accommodation costs.

Some care costs are capped in Wales, and home care is free for the over-75s in Northern Ireland.

The SNP has called on the government to scrap any planned rise in National Insurance, saying it would "unfairly penalise Scottish families by forcing them to pay the bill for the Westminster social care crisis in England".

The party's Westminster leader, Ian Blackford, added: "If Boris Johnson breaks yet another manifesto pledge, the Tories will descend even further into irrelevance in Scotland."

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