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Political courage and financial realism needed to prevent care system's collapse

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Commentary on the social care green paper.

The prime minister last weekend responded dismissively to the 90 MPs of all parties who last year called for cross-party working on proposals to put social care on a long-term sustainable footing. Theresa May’s bland statement that she was “committed to engaging with all parties on these key issues” will do little to raise expectations that the social care green paper scheduled for this summer will deliver on the government’s promise to tackle one of the biggest challenges of our time.

As the Conservative manifesto pointed out, successive governments have “failed” to muster the political courage and conviction to take decisive action to establish a desperately needed new model, particularly when faced with emotionally powerful, yet perhaps simplistic, accusations from opponents of attempting to introduce a tax on “death” or “dementia”.

Ms May’s letter, as polite as it is lacking in substance, fails to acknowledge how the required bold thinking and political consensus can come about to achieve a radical and credible new approach. Indeed, it seems the government is trying to create the impression it is capable of not only finding a long-term solution, but also eventually managing it through what is likely to be a complicated, treacherous and drawn-out legislative process.

This would require the strength and stability that was lost so completely and dramatically in the turmoil and ineptitude of the general election campaign.

If the government is serious when it says it recognises the challenges in social care, it must abandon any misplaced pride and embrace a truly collective effort to fix long-term and complex problems.

Theresa May’s letter also places an emphasis on the NHS, suggesting a continued prioritisation of the interface of social care for older people and health services, rather than the required acknowledgement of the importance of the wider system and growing demand pressure in support for working age people.

Also, as Richard Humphries, senior fellow, policy, at The King’s Fund, points out, the shifting of responsibility for the green paper from the Cabinet Office to the Department of Health & Social Care “carries the added risk of a narrower focus on integration with health at the expense of the wider purposes of good social care”.

The green paper, as Mr Humphries says, is “an early foothill in a longer and steeper journey”.

Despite temporary measures such as the social care precept and extra funding announced in the Budget, the social care system is fast approaching critical fragility, with chronic underfunding leading to increasing numbers of people in need of support receiving less, or none at all.

Implementing the reform at the speed and scale required to achieve sustainability will not only require party political differences to be put aside, but also further resources to ensure changes can be made to a system on the brink, rather than in the process, of collapse.

LGC is also carrying interviews with the Conservative chair of the Local Government Association community wellbeing board Izzi Seccombe and Liberal Democrat health spokesman Norman Lamb. We also have an article by David Pearson, one of the most senior directors of social care in the country.

Jon Bunn, senior reporter, LGC

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