A persistent mistake in the world of public services is to assume that a moral majority translates into a political one. The evidence is on your side, the finances all add up – or don’t depending on the point you’re making – and of course the consequences are dire. How can government not act, right? Then silence. You have stared into the abyss, impact analysis in hand, only to have the abyss stare back. The question is: why?
The short answer is a perfect argument often fails not because it sends ministers to sleep but the voters. Whilst many may cry foul over the state of social care, how many actually vote on it? My guess is a lot less than you think.
As frontline services go, social care is a minority breed. Adult social care provides services to approximately 1.3m people a year, the NHS deals with over 3m patients a week. To put this in perspective social care serves 2% of the UK population, or more tellingly, 1 in 9 over 65s. The answer is in the numbers, 8 out of 9 pensioners don’t use social care and if you’re not using a service there’ll be something more salient a politician can offer you. Most of us vote selfishly, I see no reason why the elderly should be any less prone to avarice than the rest of us. Free bus pass or TV licence?
Social care’s weakness isn’t a lack of lobbying or public sector waste, it’s the voters. There is no solidarity on the issue. Even the grey vote can’t coalesce around it and politicians know this. Government doesn’t want the system to collapse, and I happen to believe ministers are committed to social care, but the incentives to reform it aren’t strong. So we shovel just enough cash in each year to keep it going, like the last dregs of dried wood on a dying fire.
This year’s shovel is the same as last year’s; the social care precept. The additional levy, which councils raise from their electorates on top of council tax, is a welcome move by government, but it won’t be enough. The 3% increase in the precept generates £760m in additional revenue but this is unevenly distributed. A combination of higher yield council tax bases and low elderly populations, in London boroughs for example, means areas like Sunderland receive only £58.42 per pensioner, compared to £162.40 in Islington. Of course not all over 65s use services, but as the pressure in the system is coming from an aging population these figures highlight a fundamental weakness in the precept.
Nominally retired luminaries will suggest we need another commission on how we fund social care because, well, that’s what nominally retired luminaries do I guess. Alas, we don’t need another commission to pontificate over the inevitable question of who pays. We already know; it’s you and I.
And we’ve got plenty of ideas on how to do this too. The Dilnot commission, the Barker commission, etc… The question isn’t who pays but who cares? If we can find the voters, government will find the money. In the meantime, social care’s advocates must guard against the assumption a moral imperative will trump a political one. It hasn’t yet.
