The government has decided to review the long-term provision and funding of social care for older people. The public will be consulted on the issue, after which there will be a green paper. Interventions this week from both the prime minister, Gordon Brown, and health secretary Alan Johnson suggested the government wants the public to tell it what might be done.
The Local Government Association has been lobbying about the costs of care for older people for some time. Demographic projections show a continuing rise in the numbers of very elderly people. Costs are already rising.
Many individuals will not make voluntary arrangements for their own long-term care. The question for the state is: how far should people be compelled to provide for themselves and how far should the government, and thus taxpayers, contribute?
Local government will always find itself in the front line of difficult and unloved services such as those for the very vulnerable. Whitehall is so distant from individuals in their own homes or in care provision that it is impossible for the centre to do any more than set a legislative framework and then regulate the results. Because the services provided are for a voiceless group, there is little democratic pressure for improvement. Inevitably, resources are difficult to find.
Action, not just words
The government’s ‘conversation’ about care for older people would be more welcome if there were not a serious suggestion Whitehall is so unsure of itself that another consultation is just a way of putting off a decision. The prime minister, both now and as chancellor, has been the ultimate proponent of reviews and consultations. But at the end of the process, there is often little or no action.
Councils are already coping with the bulging costs of services for the elderly. Provision is patchy and has been increasingly restricted in recent years. The need to consult about the long-term future will not reduce pressures that already exist in virtually every major authority.
Mr Brown and his health secretary would do well to consult the LGA about the experience gained in local government about the often expensive and difficult provision needed by old people. Services are needed both for the elderly themselves and by their relatives.
There needs to be a fair and comprehensible system of funding. It is almost inevitable that individuals will, to some extent, have to pay for themselves. But to what extent, and how will saving be encouraged?
Local authorities must ensure they are not left with inadequate resources for the rising costs of provision for older people. It will be tempting for the government to develop a solution that creates a permanent ‘squeeze’ on councils.
This would be an inadequate and defective solution. Proper care for old people is a measure of a civilised society. Local government holds many of the answers. The review must not be an excuse for inaction.