Is the government going to abandon its “long term and sustainable reform of social care?”
What is going to happen to the Dilnot report? In the summer, the Dilnot Commission on the Funding of Care and Support published its report but the big question is whether its recommendations will ever be implemented by a government obsessed with austerity. An important TUC on-line seminar on 28 November will discuss the Commission’s recommendations and the political struggle that is building up around them.
Everyone knows that ‘something must be done’ about paying for social care. We have a system that isn’t really a system, with:
- Carers unable to find out what support they are entitled to;
- A lucky dip about the care you’re entitled to that depends on where you happen to live;
- Thousands of people who have to run through their resources till they are nearly destitute before they qualify for free care and support;
- What is worse, people who could afford to plan for their care needs and so avoid this trap are still left to fall into it because they are unable to build upon a reliable foundation of public support; and
- The people who are most likely to need care excluded from insurance for care needs.
And with an ageing population, the one thing we can be sure about social care is that we’re going to need more of it.
Successive governments have ducked out of doing anything about this problem, though the last one had some good proposals if they had been re-elected. The current government’s response was to set up a Commission to look into how to pay for social care, chaired by Andrew Dilnot.
And there were lots of goodies in the Dilnot report. Firstly, their number one headline was a call for increased funding. This is crucial – the ageing population also means that any solution that isn’t going to leave increasing numbers in severe hardship is going to cost more. The Left is often accused of wanting to solve every issue by throwing money at it, but this is one problem where everyone who understands what’s at stake recognises that extra resources have to be part of the solution.
The report’s main policy proposals included:
- A cap in the contribution to care costs that any individual would have to make;
- Free support for people with care needs from before they become adults;
- A standard contribution to accommodation and living costs and
- National eligibility criteria, with portable assessments.
I should be clear that the TUC has been critical of the report – it falls a long way short of our call for a National Care Service, free at point of use and funded from general taxation. But the extra funding, a national eligibility assessment (vital if people are going to be able to move from one part of the country to another) and free care for younger people would all be tremendous steps forward.
And we could also envisage using the Dilnot model to move towards a National Care Service by continually reducing the level of the cap and our initial response urged the government not to set the ‘cap’ too high. And most organisations working on social care policy and delivery were even more positive:
- “We believe the recommendations set out clear plans for long term and sustainable reform of social care” said Age U.K.
- “A strong foundation on which to build reform of the social care system” said Carers U.K.
- “We welcome the publication of the Dilnot report, as it is clear that our social care system is in need of urgent reform. We now want to see the Government publish a timetable for reform, reflecting the need to act swiftly” – RNIB
- The Dilnot report “signals what will become the moment when adult social care was put on a footing to become fit for purpose in the twenty first century” – Association of Directors of Adult Social Services.
But, right from the start, there has been a question mark about whether the government will have the courage to implement their own Commission’s recommendations.
“Andrew Lansley warns costs of Dilnot reforms need careful consideration”, The Guardian, 4 July
Certainly, it seems that the Treasury is hostile:
“But many question whether Dilnot has run out of steam, with the Treasury baulking at the £1.7 billion+ price tag …” Richard Humphries, Senior Fellow, The King’s Fund .
The government has deftly avoided making a commitment one way or the other, postponing a decision till the publication of a White Paper, now due after it has the results of yet another consultation exercise. And social care minister Paul Burstow hardly sounds resolute: he says the economic case for reforming adult social care is “compelling”, and that the government is “determined” to resolve the issue of how we pay for care.
These are the sort of phrases that are designed to sound supportive without actually being so, and he never commits to fighting within government for the necessary funds.
So this is a moment when social care is a key political battleground. The issues for unions are important – a National Care Service would be a major egalitarian step forward and it would also help us to resist the casualisation that has already taken root in care services. A service gasping for funds, on the other hand, would be even more likely to exclude the poorest elderly and disabled people and to exploit its workforce.
Which makes the forthcoming TUC seminar, The Dilnot Report – Funding Social Care especially timely. The keynote speaker will be Andrew Dilnot, with responses by Alison Roche, UNISON officer for social care and Prof Peter Beresford, Director of the Centre for Citizen Participation at Brunel University.
We’re holding this as an on-line seminar: you’re welcome to come to Congress House and take part in the non-virtual seminar (free sandwiches if you do!) but you can also take part via the web: we’ll be live-streaming the seminar on the Touchstoneblog website, with questions via Twitter and e-mail. Either way, please register to receive instructions on how to get to Congress House and how to take part on-line.