It was absolutely important that two of the main political parties decided to raise high the flag of social care at their party conferences this year, and begin seriously to put social care issues firmly in front of the electorate.
Personal care isn’t just something about elderly people. It’s about their children, their families, their neighbourhoods and communities. It is a national issue worthy of national debate, and it was deeply encouraging that, such is the way of democracy, national politicians are beginning at last to treat it as seriously as do local ones.
Earlier this year I described the current system for caring for older people as in danger of becoming `unfit for purpose’ in the future. I repeated this message, on the Association of Directors of Adult Social Services’s behalf, to a fringe meeting at the Conservative Party conference in Manchester last month.
Financial arrangements are deeply resented by service users, carers and families, while the rest of the population is either ignorant of them, or find them incomprehensible.
Meanwhile, we are facing known risks: rising demand; increasing numbers of frail older people and adults with disabilities, and a bleak economic future. We shall continue to face rising demands for all the services we currently provide or commission for a good while into the future while not enjoying anything like the sort of economic growth that we’ve witness over the past 15 years.
Although the case for change is compelling, it’s important to remember that there are two reform agendas currently being developed, clearly linked, but which need to be kept separate. There’s the funding review, involving the Green Paper options. And then there’s the delivery agenda which involves our Concordat with government and the implementation of Putting People First
On funding, a fully tax-funded system would place social care on the same footing as health care. This would have the clear virtue of being unambiguously understood by the public. But the current government has ruled it out because it places a burden on working-age people. ADASS would not be so peremptory: exactly the same argument could be applied to the funding of the NHS.
We welcomed Gordon Brown’s move towards providing care free of charge to certain categories of need, but a lot, lot more work needs to be done on the detail and resource implications. For example, we feel that some disability benefits should be included, but we need to be very careful to reassure people that the change would not disadvantage them.
Andrew Lansley’s offer of an insurance-based guarantee of residential care for all who need it without having to sell the family home is a trifle more problematic. His predecessor, Kenneth Clarke, 20 years ago responded to an out-of-control social security budget guaranteeing old people state-aided residential care by transferring it to a means-tested, eligibility-controlled local authority budget. The objective? To destroy the perverse incentive that encouraged inappropriate transfers from home to residential care, when all the policy trends were towards encouraging people to stay in the comfort of their own homes, in the community.
Without much more detailed analysis of the resource situation, and definition of eligibility, that same old perverse incentive could rear its ugly heads again, with the self’s-ame unfortunate consequences.
But it’s an ill wind… And what each of the parties has begun to move towards is, if put together, a sort of solution. Combining a pain-free way of capturing some of the near £1tn locked up in the personal, unmortgaged equity of the baby-boomer generation, and looking afresh at ways of developing a creative use of tax-based resources has to be a good start, whichever way it’s looked at.
Jenny Owen is president of the Association of Directors of Adult Social Services
