With recognition that the state needs to play a greater role, at long last a genuine policy breakthrough feels possibleby Anita Charlesworth and Charles Tallack / October 25, 2019 / Leave a comment
Official data released this week provides further evidence that the social care system in England is broken and needs fixing. The figures illustrate the mismatch between demand for care and the services available—more people are asking councils for support, but despite small increases in the number of working-age adults getting long-term help, fewer older people are receiving it. For those not eligible for publicly funded services, there is no protection against potentially catastrophic care costs. Around one in 10 people aged 65 face future lifetime care costs of over £100,000.
Fundamental reform is needed to fix a system that everyone agrees isn’t fit for purpose, but after two decades of attempts, could a breakthrough soon be on the cards?
In 1998 Tony Blair rejected the central conclusion of the only Royal Commission he established during his decade in office. Free personal care was the majority recommendation of the Sutherland Commission on the future of adult social care, which Blair said was too expensive. Two years later, the inaugural Scottish government introduced free personal care; a totemic, post devolution policy difference between England and Scotland.
Much has changed since 1998, but a viable plan to fix social care in England remains elusive. Numerous politicians, including Andy Burnham and Theresa May, have had their fingers badly burned trying to reform the system. History suggests it would be foolish to expect progress any time soon.
But this view is almost certainly too simplistic—perhaps social care’s time has come. The last few months have seen all three main parties promising that they will sort it out. John McDonnell has committed Labour to free personal care, the Liberal Democrats have said they will establish a cross-party commission to settle the matter and introduce a dedicated tax, and Boris Johnson’s Conservatives have elevated the previous government’s green paper promise to an imminent white paper.
So, what are the chances of reform? A few years ago, the OECD looked at efforts to reform pensions and employment across several countries and identified the common characteristics of those that succeed and fail. Major reforms stand or fall based on public recognition of the need to change, good evidence of what needs to happen and, crucially, effective political leadership to see reform through.