‘Cop-out’ could spell disaster for National Care Service
By Paul Roberts
www.caringforyourbusiness.co.uk
So near…and yet so far. In announcing plans to create a National Care Service – the greatest welfare reform since the launch of the National Health Service 62 years ago – the Government lost their nerve on the crucial issue of funding.
There was no ‘cometh the hour, cometh the man’ moment for Health Secretary Andy Burnham. Just as he had the opportunity to make a ground-breaking decision on how we pay for social care, he took the easy – and wrong – route out.
In a move that would have been applauded by Sir Humphrey on the BBC comedy series Yes Prime Minister, he boldly announced the Government’s plan to set up an independent commission to decide how care is to be funded.
The commission, which will almost certainly not be established if Labour lose the General Election, is a recipe for one of two things – a serious delay in making any meaningful progress or for doing absolutely nothing at all.
The Government’s much-awaited White Paper, Building the National Care Service, highlights the desire to proceed with a controversial compulsory funding option (for all those over 65 with the means to pay it).
The White Paper makes clear that the commission will only decide how, and not if, compulsory contributions will be made. So why, after a lengthy and expensive ‘Big Care Debate’, can’t the Government determine the best way forward?
There are, after all, only two viable options for compulsory funding of care – through an insurance scheme or taxation. The latter has already been rejected by the Government, leaving just insurance on the table.
The Government know this. Andy Burnham knows this. So why do they need to set up a care commission to make the decision. The answer, of course, is political – and amounts to the biggest cop-out we have seen this century.
The Government are attempting to defuse the seemingly endless row with the Conservatives and Liberal Democrats over funding ahead of the General Election – as part of an ill-considered damage limitation exercise.
With a National Care Service expected to be introduced in 2015, timing is not an issue, even with the election just a few weeks away. Labour will almost certainly lose rather than gain votes because they will be seen to have ‘bottled it’ on social care at the 11th hour.
It really is an opportunity missed. Labour offered the first real hope of reforming social care by first unveiling the Green Paper, Shaping the Future of Care Together, in 2009 and then the new White Paper, at the end of March 2010.
That hope evaporated amid the rows and wrangling in Whitehall and the debate over the Personal Care at Home Bill which is now only memorable for the vitriol it provoked and the ‘Death Tax’ controversy stoked by the Conservatives.
The Conservatives have not put social care at the top of their political agenda. The only change they actively support is the much-publicised proposal to allow people to pay £8,000 into an insurance scheme to waive residential care costs.
They do not support the idea of an all-party commission to determine how the National Care Service should be funded. The Liberal Democrats, vague to say the least on reforms they favour, believe that any commission could only work if it were free to consider all funding options.
If the political parties can’t agree on the commission on care and its purpose what hope can there be of it being set up and instrumental in driving the debate forward? Not surprisingly, Labour are being accused of taking the easy way out – and that’s how the electorate will see it.
Building the National Care Service charts a course for the ‘fundamental reform of the care and support system in England’. It recommends that the following changes occur:
1. The introduction of free care at home for 280,000 people with the highest level of needs from February 2011.
2. The introduction of ‘re-ablement’ services for 130,000 people from 2011 at a cost of £670m a year.
3. The setting up of building blocks for a national system of care and support – including national standards and entitlements – during the next Parliament.
4. The introduction of a National Care Service Bill early in the next Parliament.
5. The establishment of a National Care Leadership Group by July this year to provide expertise and support delivery of the National Care Service.
6. Free care to all residents of care homes after two years, irrespective of means. This is likely to benefit between 50,000 and 65,000 people at an annual cost of £800m.
7. The introduction in 2015-2016 of a comprehensive National Care Service free at the point of need for all adults who require care, funded by compulsory contributions.
The White Paper says the commission would ‘determine the fairest and most sustainable way for people to contribute. It will make recommendations to Ministers which, if accepted, will be implemented in the Parliament after next.
‘The commission will determine the options that should be open to people so that they have choice and flexibility about how to pay their care contribution. Our expectation is that the commission will consider all the various options for payment put forward.
…’The final stage of reform, after 2015, will then be to establish the comprehensive National Care Service, on the back of a clear national consensus on how it should be funded.’
In an article in The Guardian, Mr Burnham indicated that his preferred option remained a compulsory levy of some form, but he said further work was needed to create a ‘political consensus’, thus the need for an independent commission.
In an interview on BBC Radio 4′s Today programme, Andrew Lansley, Shadow Health Secretary, said the government had ‘ended up not with a White Paper but with a train crash’. He said a compulsory system was ‘unfair’ on people who paid for their own care.
Social care leaders have rightly condemned the Government for prevaricating on funding, accusing Mr Burnham of putting social care reform in jeopardy. After months of debate and wrangling, he and the Government again have to prove that they are not just playing with social care reform.
