Sustainably funding a marginal welfare programme

English social care for older people faces a funding crisis. After more than two decades of growth, public spending on residential and home care fell in the years of financial austerity that followed the Great Recession, leaving almost half a million fewer older people eligible for publicly funded care and support. Social care is a non-core welfare programme financed by a secondary area of the English state that has suffered significant reductions in spending over the past decade. Policymakers recognise that social care has a structural funding problem, and there is a broad consensus that an alternative sustainable funding approach is needed to deliver more appropriate and equitable levels of social care provision, but policymakers have consistently failed to reform how social care is funded.

This book argues that two very different institutional poles have emerged in England that deliver sustainable welfare programme funding: legacy positive state institutions that joined the welfare state core in the golden age of welfare, and more recent non-core welfare institutions where policymakers have engineered devolved, non-taxation funding approaches. Public social care is a significant, mature and complex welfare institution that is supported by neither. Moving English social care towards the positive welfare state core has proved to be technically and politically unworkable, and less than fully engaged policymakers have been unable to agree on a bespoke, programme-specific funding solution designed to deliver greater sustainability. Elsewhere, it has been possible to enact successful sustainable funding reform in marginal policy areas, when policymakers have looked in the policy garbage can and found that an established, pre-existing institutional answer to the funding problem already exists, allowing the politics of organisational change to follow the structure. While English policymakers might express a desire for change, the existing funding approach has been undermined by a decade of austerity, and history has not left social care a clear route to an alternative de-centred funding solution.