It’s time to stop the politicians from turning social care into a debacle
By Paul Roberts
www.caringforyourbusiness.co.uk
How could it have come to this? The ‘Great Debate’ on the future funding of social care is in ruins. Squabbles at the highest level have reduced the issue to a ‘political football’ that is in danger of being kicked so far out of sight it may take years to get it back on the ‘pitch’ and in sight of ‘goal’. Our politicians seem hell bent on turning a bright new future for social care into a debacle.
Hopes were high that the beginning of 2010 would herald revolutionary changes for home care for Britain’s ageing population. The Government’s green paper Shaping the Future of Care Together appeared to provide an important new platform for setting a new and meaningful agenda for social care provision in the UK.
Here was an opportunity for new initiatives – with political differences put aside to tackle one of the great challenges of the 21st century. Here was an opportunity for the three main political parties – Labour, the Conservatives and the Liberal Democrats – to demonstrate that they could rise above politics to offer some genuine solutions to the crisis we face.
But they blew it. They have turned the ‘Great Care Debate’ into an ugly farce now only memorable for the bickering, points scoring and schoolboy antics. Rather than care for the elderly taking centre stage for the next General Election, the single biggest social issue facing the UK is becoming the victim of gutter politics.
The new Personal Care at Home Bill – the first step towards creating a National Care Service – is expected to be derailed because of concerns over the cost of providing free care at home for hundreds of thousands of people with the greatest need. More than 70 councillors have written to The Times expressing concern at how the estimated £670 million annual cost would be met.
Labour and the Conservatives can’t agree over how the elderly should pay for their care. The Government is increasingly leaning towards a controversial compulsory funding option (for all those over 65 with the means to pay it). The Conservatives appear to prefer a voluntary insurance scheme, although their intentions remain substantially unclear.
The Liberal Democrats meanwhile have dismissed the Personal Care at Home Bill as ‘fundamentally flawed’ having initially supported the legislation. They, along with a number of other critics, argue that it amounts to ‘back-of-the-envelope’ electioneering from the Prime Minister, has not been costed properly and could detract from other services.
The Liberal Democrats, through their leader Nick Clegg, unveiled an alternative scheme – for unpaid carers who look after relatives for more than 50 hours a week to get a week’s holiday cover out of money set aside by the Prime Minister for free care. The idea has already won widespread support, particularly among the army of unpaid carers in the UK.
The row over social care reached a new low with politicians being accused of stooping to gutter politics (by claiming social care change would be at the expense of disability benefits). Amid the recriminations and misunderstandings, there have been numerous spats between ministers and shadow ministers and playground antics that should shame all those involved.
The Conservatives unveiled a less than helpful tombstone poster campaign accusing Labour of planning a ‘death tax’ by favouring a compulsory funding scheme for care. Lord Mandelson, the Business Secretary, hit back at the Conservatives, accusing them of ‘driving a wrecking ball’ through the care debate.
So, just as the people at the centre of the new social care agenda – the elderly – have been beginning to get to grips with the debate, the politicians have seriously muddied the waters with stinging attacks, changes of heart (and policy) and pathetic points scoring. Now we are all left in a state of complete confusion and despair.
Fortunately, there have been sensible and measured responses to the Personal Care Bill from professional organisations. The Association of Directors of Adult Social Services (ADASS) have called on the government to part-fund personal care at home for people with high needs rather than make it free – to ensure the policy is affordable for councils.
ADASS have warned that the government’s estimated price tag for the legislation - £670m – was underestimated and was more likely to cost £1 billion or more. With the Department of Health only funding £420m a year and councils expected to stump up the rest, any shortfall could leave authorities out of pocket.
The Local Government Association (LGA) and the United Kingdom Home Care Association (UKHCA) said the government’s free personal care plan was underfunded and underestimated demand. The LGA warned of its ‘serious reservations’ about the predicted demand for free care and that local authorities could be forced to make cuts to meet the high demand.
The UKHCA said the independent homecare sector would ‘struggle to meet the extra demands of free personal care if local authorities have insufficient funds to meet providers’ costs of supplying high quality, effective, homecare services’. This, they said, could lead to pressure on wages and increase the already high rates of staff turnover in the home care sector.
While our politicians play their games, the future remains bleak. Britain’s elderly population is increasing daily and the Audit Commission have recently reported that most local authorities have yet to produce plans for how their services will be affected by the growth in the number of over-65s over the coming decades.
The failure to plan and reform services now will increase the risk that care services will be unaffordable – or not available – when many of today’s workers come to retire. The care time bomb is ticking ever louder and time is running out to establish and put in place solutions to avoid a crisis beyond control.
Recent studies – including one by the poverty charity Elizabeth Finn Care – show that more than half of today’s professionals, aged between 35 and 45, will face financial problems in retirement if they are left without an inheritance. In fact millions of people may not be able to afford care if we fail now to meet the funding challenge.
We don’t need to dig deep to see what is happening today. A new study by the London Assembly has revealed that as many as 165,000 elderly people in London with care needs are being forced to pay for their home care because they can’t claim assistance from local councils. Only three quarters of councils in London are able to fund home care services for those with ‘critical and substantial’ needs.
So how can our politicians get us out of this shambles? First and foremost, a decision has to be made on funding. Amid all the confusion and histrionics, The King’s Fund have suggested a credible option – a ‘partnership’ scheme under which the state would provide a basic level of care with incentives for people to ‘top up’ the provision.
The compulsory funding option first raised in the green paper launched in 2009 (involving a fee of up to £20,000, which could be taken from an individual’s estate after death) may be unpalatable for many, but may be the only realistic way forward. Why? Because too many people would choose to opt out of a voluntary scheme, undermining the system and potentially leaving social care in a bigger mess than it is today. The Association of Directors of Adult Social Services (ADASS) are backing the option. The Conservatives are not but have yet to unveil their own plans for the future.
Almost 20 charities involved in care for the elderly and long-term sick have issued a call for an end to the squabbling. Their voice needs to be heard above the cheap jibes and vitriol in Parliament to give Britain the chance to salvage something from the wreckage of the debate on social care reform. It’s not too late – but there’s very little time to lose.
May 3rd, 2010 at 10:40 am
Good post, thanks
July 16th, 2010 at 1:32 pm
Love your blog! You write some interesting posts over here. Keep up the good work!