Lib Dem sums on health and care pledges ‘simply don’t add up’, says think tank

Leader Sir Ed Davey said he wanted to put ‘fixing the care crisis at the heart’ of the party’s offer to the country.

Liberal Democrats leader Sir Ed Davey
Liberal Democrats leader Sir Ed Davey (Lucy North/PA)

Liberal Democrat pledges on health and care are ambitious and brave but the sums to make them happen “simply don’t add up”, a health think tank has said.

The party, which last week announced its plans to bring in free personal care to help people live independently at home “wherever possible”, published its full manifesto on Monday.

Leader Sir Ed Davey said he wanted to put “fixing the care crisis at the heart” of the party’s offer to the country.

But independent health organisation the Nuffield Trust said while it welcomed the party having dedicated a chapter in the manifesto to the adult social care system, the proposed funding appears to fall short.

Its chief executive Thea Stein said: “The measures in the Liberal Democrat party manifesto outlined today are ambitious and show that in some important areas the party has taken good calls on difficult issues about what to prioritise.

“There is an impressive detail of commitment, picking out neglected areas like the mental health of new mothers and the dysfunctional pay review system for NHS staff.

“However, the funding proposed appears insufficient, and social care proposals would not achieve the goal of coverage that is equivalent to the NHS.”

The party said the provision of care should be based on need rather than ability to pay, and said personal care could cover nursing care and help with mobility, hygiene and medication.

But the Nuffield Trust said the personal care pledge is for “a narrow set of services to help with the basics of living and is not equivalent to free social care which encompasses broader support”.

It described the costings as appearing to be “an underestimate”.

She added: “The real sting in the tail of this manifesto is that the sums to support these worthwhile aspirations simply don’t add up.

“It’s unclear from the costings document exactly what the £8.35 billion pledged to cover the NHS and care pledges is based on. Just freezing the NHS budget in real terms would require more money than this by 2028/29.

“Even in the most generous interpretation, a real-terms £8.35 billion increase above the planned budget for this year, would result in annual increases in the region of 2.8%.

“This is lower than over the last decade, lower than the long term average of 3.6% and would not meet the OBR’s (Office for Budget Responsibility) estimates of the funding needed to pay for the existing NHS long-term workforce plan.”

But she described the policymaking as “brave” and said it “should be applauded in the context of straitened finances”.

She called on other parties to show “equal seriousness” in committing to plans to tackle problems in the stretched sector, and said “political willpower” is now needed “to enact bold reform”.

The party last week stated its plan covered social care for those over 18, including working age adults, the elderly, and the disabled.

But Sarah Woolnough, chief executive of the King’s Fund health charity, questioned whether the free personal care would apply to older people only or extend to working age adults living with disabilities.

However she praised the Lib Dems for being “the only major English party proposing much-needed reform of social care” and said the plan was a “significant step forward” and would increase many people’s access to state-funded care.

Vic Rayner, of the National Care Forum which represents not-for-profit organisations in the care and support sector, commended the manifesto pledges as “a welcome and refreshing change to how care has previously been positioned as an endless series of issues to be kicked around and ultimately dismissed”.

But a spokesperson for the Children’s Charities Coalition said it was “disappointing there’s barely any mention of children’s social care, in stark contrast to the commitments on adult social care”.

The coalition, which includes Action for Children, Barnardo’s, the NSPCC, National Children’s Bureau and the Children’s Society, said: “Ed Davey has spoken up powerfully on the importance of championing carers and we would welcome him making a commitment to being a champion for children.”