Demos’ response to social policy reform in the Conservative Party Manifesto

Social Care

Social care currently has a means and a needs test – in other words, you have to be both really poor, and really ill, to get funding support from your council.

The Conservative manifesto pledges to change the means testing element of this – shifting the benchmark upwards so that those with assets worth more than £100,000 have to pay for all of their care. This calculation includes the value of a person’s home, so the vast majority of home-owning older people will find they have to pay. This may seem unfair, but the current asset threshold is already very low (£23,250) – meaning not only all homeowners, but many social renters with modest retirement savings also have to pay for all of their residential care. The large jump in the threshold will means hundreds of thousands of the poorest older people will have access to partially or fully funded residential care for the first time. 

However, the substantive difference in the manifesto is that the asset test will now also apply to care in one’s own home. This has been widely criticised, as it will expand the number of self-payers substantially in this market. It does, however, bring parity between residential and home care, and improving the clarity of the assessment system. It may also make it easier to move between care in one’s own home and in residential care (and back again). Up until now, this was never seen as viable, as people often had to sell their home to pay for residential care. The value of one’s home was excluded from home care, because it could lead to ridiculous situations where people had to sell their home in order to pay for care (in that home). And once one sold up in order to pay for residential care, a move “back home” would never be a prospect.

Mental Health

A new green paper on children’s mental health is a welcome development, hopefully setting out some new ideas on how young people can access services early on rather than contend with patchy coverage and extensive waiting lists in the current regime, and ways to smooth the transition from children’s to adult mental health services which remains a disruptive process for many.

Mental health first aid training for teachers will be an excellent way of spotting problems early and raising awareness generally of mental well-being. Of course, the devil will be in the detail and such training needs to be adequate to the task rather than a stray hour given over to the basics in a teacher development day. Again, perhaps the green paper will flesh this out further, as well as they ways teachers should appropriately take action.

Some may feel this is placing a new burden on teachers – giving them responsibility for mental health diagnosis where GPs and other medical professionals should be playing a part. Not so. Teachers are in contact with young people for more hours per day than any other professional. Children spend more time at school than at home, and teachers already are faced with young people with mental health needs and tackle challenging behaviour on a daily basis. Arming them with some training – and importantly this is being termed “first aid”, not a replacement of professional mental health support – can only help them do the job they are already doing in providing pastoral care for their students.

The reform of CAMHS is long overdue, and the manifesto focuses on the right things – delays and the prevalence of out of area treatment caused by patchy local coverage of services. But understanding what the conservatives mean by an “appropriate time frame” for treatment, and how they will ensure everyone has access to “normal treatment” locally without a substantial investment in the coverage of local treatment centres are both central to the impact of these pledges.

Children in Care

The pledge to remove family support and child protection service responsibilities from poorly performing local authorities and placing them in trust is a short-sighted and inefficient response to underperformance – local authorities need help to improve, the government ought to be working with these councils to build up skills and capability, rather than simply take their responsibilities away. Parachuting in experts and change managers and developing partnerships between high and poorly performing councils to share knowledge and expertise are just some ways this can be achieved, so that all councils learn how to effectively commission child and family support services

Disability, costs and employment

The opening line of the disability section of the manifesto – “we will build on the proud conservative record in support those with disabilities…” will feel like a slap in the face for those who have been affected by the last 7 years of welfare reforms, which saw at least £28bn taken from the pockets of disabled people. As Kathy Mohan succinctly told the PM in Abingdon last week, “I want my DLA back.. I can’t live on £100 a month.”

There is barely a mention of these reforms in the entire document – given it was a central and defining plank of the previous conservative government, this speaks volumes. So too does the line “We will continue to ensure a sustainable welfare system, with help targeted at those who need it most” – which means, essentially, that Theresa May plans on simply continuing with the controversial and damaging cuts Cameron, Osborne and IDS introduced. The Bedroom Tax, the welfare cap and freeze in uprating, PIP replacing DLA and damaging work capability assessment all stay in place, signalling no end to the current state of affairs for disabled people. Kathy won’t see her DLA money come back any time soon.

While welfare reform is in a grim holding pattern, there does seem to be some movement on employment support – with an encouraging focus on tackling employer attitudes and practices, and labour market flexibilities to make work more accessible for more people. This supply side theme continues – improving housing and parking accessibility, and looking at energy and telecoms markets to tackle higher living costs for disabled people. These are important and very welcome steps towards a sustainable strategy for tackling disability poverty – not just focusing on increased incomes, but reducing costs through consumer rights.