Britain must solve its social care crisis if “any good” is to come from the coronavirus pandemic, the boss of NHS England has warned.
A properly resourced service could be the consequence of coronavirus just as the NHS was one of the legacies of the Second World War, Sir Simon Stevens said.
In a stinging critique, he warned the UK system did not provide high-quality care for his parents’ generation.
Ministers have also faced accusations that they failed to protect care homes as Covid-19 swept across the UK.
Almost 20,000 deaths in care homes across England and Wales between March and June have been linked to coronavirus, according to official figures.
Successive governments have promised to reform social care, in a bid, among other things, to ensure people are not forced to sell their homes to fund their place.
But plans to change the system have been repeatedly deferred.
In a speech last week Boris Johnson, who on Sunday led the nation in a clap to mark the NHS’s 72nd birthday, said that now was the moment to fix a series of problems, including those in social care.
Sir Simon told the BBC's Andrew Marr Show the coronavirus pandemic had shone a "very harsh" spotlight on the resilience of the social care system.
He said: "And if any good is to come from this, in my opinion, we must use this to resolve once and for all to actually properly resource and reform the way in which social care works in this country.
"The reality is that after at least two decades of talking about it, we do not have a fair and properly resourced adult social care system."
Plans to adequately fund the service need to be in place within a year, he added.
He said he hoped that by the time the UK was celebrating the NHS's 73rd birthday, a year from now, "that we have actually, as a country, been able to decisively answer the question of how are we going to fund and provide high-quality social care for my parent's generation."
Sir Simon conceded that the solution would be expensive and possibly controversial.
But he drew a parallel with the creation of the NHS after the end of the Second World War.
At a time of rationing and amid great uncertainty about what the UK’s post war reconstruction would look like the founders of the NHS “did not use that as a moment to hesitate”, he said.
Instead they said “let one of the legacies of the war be the creation of the NHS. That's the same legacy we need for long-term care … coming out of coronavirus.”
Sir Simon also warned there could be "very significant" extra costs to the NHS later this year around a large-scale flu vaccination campaign, which he said he thought would have to be the largest the UK has ever seen, personal protective equipment (PPE) and sustaining extra hospital beds.
Asked how much it would cost, he said: "That is a dialogue we are having, but all the signs are that we will get the support we need."
Earlier Matt Hancock, the Health Secretary, played down reports that ministers were locked in a row with the NHS over a request for an extra £10 billion this year.
Mr Hancock also said he wanted to see NHS staff rewarded for their service during the coronavirus crisis, but stopped short of backing calls for a pay rise.
Asked about salaries, Sir Simon made clear that he wanted to see frontline health service staff "properly rewarded" for their work.
Sir Ed Davey, the acting Liberal Democrat leader, backed Sir Simon’s call for action.
“If there is one thing we know from coronavirus it is that our social care sector is in a terrible mess. It is underfunded, staff are underpaid and the difference in services and outcomes across the country is massive.”
A spokesman for the Department of Health and Social Care said: “The social care workforce are playing an essential role in the fight against Covid-19 caring for our loved ones during a challenging time and we have set out a comprehensive action plan to support the sector in England throughout the coronavirus outbreak.
“We know there’s a need for a long-term solution for social care and there are complex questions to address. We will bring forward a plan that puts social care on a sustainable footing to ensure the reforms will last long into the future.
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