Andrew Dilnot’s impossible task
It is now nearly five months since the Dilnot Commission’s report on the future funding of social care was published. This was the Commission that was given the unenviable task of coming up with proposals for sustainable future social care funding which would gain a significant consensus of support. This at a time of unprecedented cuts in public expenditure under the banner of cutting the public deficit. Small wonder then if the Commission falls short in any way of achieving what seems like a nigh impossible task.
Now while almost five months have passed since the report’s recommendations first saw the light of day, if anything we are even less clear than we were on the day of its publication what their fate will be. There’s been a lot of talk about them being kicked into the long grass by the government. The treasury has seemed less than enthusiastic about Dilnot’s proposals for additional public spending, however modest it might seem. Yet this was a Commission that was highly conscious of the need to produce sustainable proposals that would gather some serious political consensus around them. You might say if the present apparent lack of progress is their reward, what more could ever have been expected for social care from this government, given the Dilnot Commission’s determination to come up with feasible, achievable, politically savvy recommendations?
Social care policy brings to mind a range of well known sayings and clichés. These include:
- Squaring circles
- Making bricks without straw
- Finding magic bullets
- Producing better for less.
All are occasioned by social care’s inherently conflicted history and nature. It is indeed a Cinderella policy from which more is constantly demanded, while enough has never been made available to fund it properly. For years social care has had to keep going with general recognition, even official government recognition recently, that it hasn’t got enough money to be the service it needs to be and that it isn’t really fit for purpose.
Looked at in this light, the task set Andrew Dilnot to provide proposals for a sustainable system of social care that could command consensus, looks less like addressing a meaningful policy briefing and more like having to resolve impossible contradictions. No small order, particularly, given that in England, as yet, we have no experience or direct knowledge of what such a sustainable and effective system of social care would even look like.
By all accounts Andrew Dilnot and his fellow commissioners came up with an imaginative and original set of proposals. Yet so far the muted response they have received from government and its departments, means that the rest of us have been asked to get behind them to give them at least some force.
We are encouraged to rally round them ‘the only game in town’. But this is not a game that looks set to go. It doesn’t offer the sustainable funding system that we need – and which the Dilnot Commission was asked to provide, because always Mr Dilnot had to keep his weather eye on another issue that flies in the face of achieving such an outcome – political short-termism.
It’s not just that the private sector has so far shown little enthusiasm for Dilnot and his arithmetic still looks like leaving many people paying a lot for their social care. Even with the very limited additional public money which the Dilnot recommendations required (much less than the £6 billion tax bill, for example, that the government let Vodafone off), the Dilnot maths seemed to make the government nervous. Andrew Dilnot seems to have been set an impossible task, squaring circles, making bricks from straw, searching for holy grails and magic bullets that just don’t exist. Maybe though that is the real point here. Should any of us take on tasks so circumscribed by political constraints and ideological considerations that they are never likely to deliver? The answer to that philosophical question may only be found in the conscience of each of us. More to the point, failing to find a sustainable long term solution for social care funding now, merely means that we will be forced at some point to start looking more carefully a little further down the line. This is one problem will never go away, least of all so long as the numbers of old and disabled people continue to rise in scale and importance.