They say that if it walks, looks, quacks and paddles like a duck, then it probably is a duck. The same goes for politics. In a democracy, when you start talking about upwards of £20bn of public money and several million votes, politicians are probably going to start doing politics. It is, after all, what they do.
So nobody should be too surprised that the social care content of the Queen’s Speech this week gave rise to mutual recriminations from all the leading parties. Yes, the issues surrounding adult care, and the wider policies in the Green Paper Shaping the future of care together, have been, and will be, used by politicians for political ends. In many respects, that should be entirely welcomed.
Because both heat and light have been shed on the issues ever since Gordon Brown announced to the Labour Party conference his intention to provide home care free to older people in the highest categories of need. And ever since Andrew Lansley, the shadow health secretary, announced to the Harrogate National Social Care Conference plans to provide an insurance-based answer to people’s fears of having to sell their property in order to pay for their care.
Wherever you look, despite the heat, some light seems to be breaking through. A first rate article in the Daily Telegraph by Mary Riddell excellently summarised the options, the policy options and the political tensions. That, itself, followed a first-rate discussion on the BBC’s Woman’s Hour about continuing care dilemmas, and further news debates on the medical aspects of dementia across the broadcast media.
And, of course, Lords Lipsey and Warner went hammer and tongs on the front page of The Times this week, taking the government to task over the well-discussed problems associated with tax-funded solutions to the provision of personal care.
No points for spotting the obvious: there are electoral calculations being made here, and we’re all grown up enough to recognise it. More points available, though, to those who spot the lateral benefit. Increasingly the arguments, the dilemmas, the demographics, the options and their place within the macro-economic environment are gradually, clumsily but with growing effect, becoming part of a better informed public debate.
Yes, it is messy. Yes, locally, in our own authorities there is still a lot to do to build on the excellent information and advice work being done by our communications teams following the Putting People First agenda. But getting the public’s understanding and involvement is vital.
Vital, because substantially more resources will have to be put into adult social care from wherever. Vital because some tough choices have got to be made in a context where wealth in England overwhelmingly lies in the hands of the over-50s – the very the people who will be most in need of social care over the next 20-30 years.
Is it right to ask younger, indebted and less wealthy tax payers to subsidise them, when the demographics paint the increasingly familiar figure of greater longevity on the one hand, bringing greater end of life dependency. While on the other, the numbers of young people in work decrease as a proportion of the whole?
Politicians, not surprisingly, have their eyes on a short-term, fierce electoral battle within the next six months. It is perfectly proper for others to look at the mid-term and beyond: to look past the next election and try to ensure that when the dust has settled, political heat can turn to policy light. Already both of the biggest parties have owned up to liking some parts of the jig-saw puzzle.
There is certainly a case for reviewing the extent to which a tax-funded, non-means tested element could be applied to cases of the highest need – though it must be fair, it must be properly and equitably funded, and it mustn’t increase the amount of confusion and bureaucracy that can attach to such solutions.
And there are already arguments within the Green Paper that could mean there were reduced threats to property-based assets through an insurance mix and match. Some means of re-assuring the insurance industry – as recommended elsewhere by Lord Lipsey – by capping individuals’ liability - are also having a new day in the sun. So whoever wins the next election will have the seeds of a universal, system-wide solution at their disposal which will undoubtedly have to bring in wider elements of the NHS than have hitherto been included.
There will be outstanding hurdles: the precise nature of the balance between national and local resources is a thorny issue which is unlikely to be resolved before next May. Using the phrase National Care Service does have the enormous virtue of raising social care’s public profile. But it will also have the enormous drawback of suggesting that services will be provided free.
And so far the political drivers which have squeezed debate into arguments about funding services for older people have threatened to put our obligations to people with physical and learning disabilities, and mentally ill people, in the shade. That should not be allowed to happen. Nor should their interests and wellbeing be neglected or over-ruled in the rush to reassure anxious older people.
One colleague director mentioned recently that she’d had more requests from councillors in the past month asking about social care issues and budgets than she’d ever had before. Directors of adult social services can expect more interest in these areas in the coming months, nationally and locally: and we should be glad if it.
Jenny Owen is president of the Association of Directors of Adult Social Services
