It’s all very difficult. That seemed to be the gist of Health Secretary Andy Burnham’s speech, as he launched this week’s long-awaited green paper on care for older and disabled people.
It’s a difficult debate, he said, which raises difficult questions about funding. The minister used the word several times.
But what’s so hard to grasp? Doing the demographics for a fast-ageing population is not like mapping the course of swine flu. There are some simple, well-rehearsed statistics we can all understand.
Like the fact that the proportion of the population reaching retirement age is due to double by mid-century, and an extra 1.7 million adults in England will need care services by 2026. Or that in 20 years there will be a £6bn shortfall in funding for even the existing care system. It’s not rocket science.
What is difficult is summoning the political will to do something. The green paper has a tentative stab, with its menu of co-payment proposals ranging from a compulsory insurance scheme, with a £20,000 per head premium, to a more modest form of partnership funding. There are also plans for a new national care service, with a focus on prevention.
All of which would be mildly interesting if (a) we hadn’t already had numerous long-term care commissions and reviews – from Sutherland to Wanless – whose detailed recommendations were kicked into the long grass; and (b) if any of the schemes had a chance of being rolled out before 2014.
All the previous attempts to reform the woefully inadequate care system foundered (in England and Wales at least) on grounds of cost. With all parties signed up, in the laconic words of Business Secretary Lord Mandelson, to a decade of ‘greater public spending constraint’, the chances of progress are slimmer still.
The government’s proposed solution is to make the public cough up more for its future care needs – and, as Ray Jones notes in his blog – to raid the disability benefits budget to meet the spending gap.
But if there is an unreal, and uncosted, quality to the new care package, the Conservatives have no alternative either – beyond some vague calls for a ‘partnership approach’.
Older and disabled people have already waited a long time for improvements to their Cinderella services. On current performance, it looks like the wait is far from over.
