Politics

The Guardian view on a new social care plan: too little, too late | Editorial


Damian Green’s proposal that a new system for funding social care for old people should be modelled on the pensions system is the latest attempt to address one of the most vexed areas of domestic policy – and one of his party’s most serious failures in government. Since Mr Green was once de facto deputy prime minister, it also offers clues as to what a much-delayed green paper on the subject might say. Both Tories and Labour have had their fingers badly burned by this issue, with the unpopularity of Theresa May’s “dementia tax” plan blamed for Conservative losses in the 2017 election. Since social care is devolved to the Scottish, Welsh and Northern Irish administrations, Mr Green’s plan is mostly relevant to England – although any changes could be expected to have knock-on effects.

The problem that Mr Green is trying to solve has several aspects. But the key point is that funding is required to maintain and expand care services, and to pay for them. The situation is urgent, because the population is ageing rapidly. There are 5.3 million over-75s in England. That figure is expected to double in 40 years. Meanwhile, failure to address problems in the short term is putting huge strain on the NHS, and causing many thousands of people to suffer. Mr Green’s paper, for the rightwing Centre for Policy Studies thinktank, estimates that delays in moving older patients out of hospitals cost around £1bn a year.

Needless to say, councils do not have the money to plug the gap. Already, 20% of all local authority spending is on social care for the retired. Meanwhile, staff turnover is unacceptably high, and standards in some places unacceptably low. Readers will likely be familiar with painful stories of rushed home visits, and minimum-wage workers struggling to meet targets – even if they have not experienced them. The wider public is well aware of the injustice of a system that sees the cost of treating diseases such as cancer met by the state, while the different demands of an illness such as dementia are not.

While there is a degree of consensus over all the above, this breaks down when it comes to what to do, and how to achieve the pooling of risk that is widely seen as desirable. Labour’s last attempt, before the 2010 election, was derided by Conservatives as a “death tax” because it featured compulsory contributions. But almost a decade on, a 1% rise in national insurance for over-50s is what Mr Green suggests, along with a tax on winter fuel payments. On Monday, Labour’s John McDonnell hurled the insult right back. Mr Green’s scheme, he said, amounted to “a tax on getting old”.

In any case, even if the green paper is finally produced, there is no chance of legislation being passed before a general election. The subject is far too difficult for our riven parliament. When a new government takes office, and provided that the Brexit impasse has been resolved, it could then have a go. Mr Green’s idea of a social care entitlement modelled on the basic state pension, topped up via insurance policies, and designed to revitalise competition between providers, is naturally attractive to Conservatives. A leftwing alternative sees social care much more closely integrated with the health service and funded either via general taxation or wealth taxes, with a decreased role for the private sector.

But the backers of either set of arrangements must seek to win cross-party support, not just in parliament but outside. The public needs to become better informed – not least because people are likely to have to make some choices. Care concerns us all, and while ideas about how it should be delivered and funded are, of course, political, a narrowly partisan answer to the social care question will not do. Our politics has rarely seemed less equipped to deliver it, but what is needed is a degree of consensus – and the kind of courage that has for too long been lacking.



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