The UK government confirmed this week that the national insurance rate will be increasing by 1.25% from April 2022 to fund the social care sector which has seen long term neglect and lack of funding. This lack of funding has reached disastrous levels only worsened by the coronavirus pandemic and the effect of increased life expectancy across society. The changes have received criticism from Labour leaders and the general public alike, with tory minister Robert Buckland stating, "The British public are sensible enough to know that when it comes to the issue of social care we have to find some way in which it will be adequately funded,". Different figures were initially reported for the proposed increase, including 1% from Downing Street, 1.25% from the treasury, and 2% from the Department of Health before the 1.25% figure was settled. Talks on the 3rd September 2021 concluded with a stark warning from health leaders the proposed figures may only raise £5 billion, instead of the £10 billion they require.
Jeremy Hunt, the former health secretary, stated that the national insurance rise will disproportionately affect the young, and the raising of funds may be better achieved through a levy, a premium, or through tax. In his estimates, a pensioner can cost up to £4000 to treat in hospital, if not higher when considering specialist surgery. Hunt is not the first to suggest that the beneficiaries of treatment should also be required to contribute – and those with larger salaries would certainly contribute more if this was based around income tax. A 1.25% rise in NI for the average person could easily mean £150-250 a year extra. Other, more harsh critics on Twitter suggested, “can we not fund the NHS with the £350m a week we supposedly saved from Brexit?”.
The impending review into health and social care (promised since 2019), is expected to recommend an increase in the amount of money people will be expected to pay for social care, a ‘cap’ on expenditure. The Dilnot review recommended a £25-50,000 cap, but this figure could go north to £100,000, blocking many people from being able to afford social care such as care homes or community residence. Not only does this raise ethical questions for those who have long term, debilitating conditions, but it is an overly simplistic way of addressing a more grass roots, fundamental problem. Health care usage has continued to increase, especially due to COVID-19, but long before SARS-CoV-2 escaped from the inner bounds of Wuhan there were clear issues contributing to high healthcare occupancy in the United Kingdom.
Many of the issues which cause bed occupation in elderly individuals such as hip fractures, heart attacks, falls, strokes and cancer are largely preventable, and point much more towards the lifestyle of western society. Throwing more money at the problem won’t fix the root cause, and many of the contributors to poor health and disability in the United Kingdom are diseases of sedentary lifestyles, poor diet and substance use. One asks the question – could a larger tax on non-essential items such as cigarettes, alcohol and junk food go directly towards funding care directly linked to their over consumption?
Rightly, the changes have caused alarm in both the medical and political spheres, and once again it appears those with the least may have to contribute the most. Although the review in social care is overdue, rushing legislation through to get a solution is not a prudent way to tackle a multi-faceted problem. And again, money will not solve this issue in its entirety. We must address the underlying societal and psychosocial factors which contribute to poor health, disability, and increasingly, mental health issues. An aging population only means more and longer healthcare will be required by an ever-increasing percentile of those over 65 years of age. There are no easy solutions, but we must not find solutions in haste.