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Back to square one on the social care solution

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Commentary on seven years of dithering.

The government has finally made a decision about something. No really! It has!

So what is this dramatic development, this proof that Brexit has not caused an insurmountable policy log-jam and an indication that ministers are able to deal with society’s greatest problems, despite their lack of parliamentary majority?

The decision announced today was not to go ahead with the proposed cap on care costs, which had been intended to ensure no family bore an unfair burden of a relative’s care.

In a statement to the Commons, care minister Jackie Doyle-Price confirmed a social care green paper will be published “by summer 2018” and would include proposals to place a limit on the care costs that individuals face.

However, she continued: “To allow for fuller engagement and the development of the approach, and so that reforms to the care system and how it is paid for are considered in the round, we will not take forward the previous government’s plans to implement a cap on care costs in 2020.”

A majority of people in local government would probably agree with Ms Doyle-Price’s decision. Why prioritise preserving the estates of relatively wealthy care recipients above dealing with the immediate funding crisis facing social care? And there is little doubt that this is a crisis. The Competition & Markets Authority’s intervention last week, warning that care homes with significant numbers of council-funded residents were unsustainable, is just the latest indication of the scale of the sector’s woes.

It may be the right decision but, as King’s Fund senior fellow Richard Humphries pointed out, six years after the Dilnot Commission, which was designed to find a solution to care funding once and for all first reported, we’re “back at square one”. Over the intervening period social care has been squeezed amid the dramatic cuts inflicted on councils and the growing demand for services. The timeline of Conservative-led governments’ actions on social care this decade does not make happy reading, despite a bold start:

Limbo followed. Inevitably social care was absent from the post-election Queen’s Speech. Although a green paper was announced, this was recently put back until 2018.

Precedent hardly fills one with optimism that this latest green paper, from a weak and distracted government, will do anything to get to grips with the issue. And even if it does, it is hard to believe ministers possess the power to implement its provisions.

David Cameron recently made a rare political intervention on the issue in his unlikely new role as president of Alzheimer’s Research UK.

“The disappointment I had was I was hoping that a combination of the cap on care costs would help to deliver an insurer’s model, where a market would grow up where everyone could insure themselves against the cost of long-term care,” The FT reported him as saying. “And we just haven’t cracked that yet.”

The fractious nature of the care funding debate means it is unlikely any coherent solution to this problem can be cracked and implemented soon. Theresa May made a fateful mistake by concocting a solution in private with her two closest advisors and then revealing it at the most politically charged moment possible – the middle of an election campaign.

This is not to say that her instincts were entirely wrong. Taxing the estates of care recipients is a fairer means of funding care than the present combination of rationing care and leaving the next generation to pay many of the costs. One might argue inheritance tax, rather than placing excessive burden on the families of those with long-term care needs such as dementia sufferers, would be fairer still. But implementing anything like this seems too politically difficult (putting it mildly) in the current climate.

So, seven years after Dilnot was announced, we’re back at square one. One fears political timidity means it is hard to envisage a solution in the next seven years. However, the care system is facing collapse. Unless we see radical action soon the consequences are unimaginable.

Nick Golding, editor, LGC

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