Attempts at reforming the care system have been stymied over the years by political barriers. We need an independent Office for Care and Living to educate the public and hold politicians to account
The English social care system is characterised by unmet need, excessive rationing by local authorities, over-burdened carers and families facing up to ‘catastrophic costs’. However, the resources required to fix these issues are relatively modest compared to the resources of the state, society and – in particular – the older population. Ultimately, the problems of how social care is funded in England do not derive from a shortage of resources and money.
Yet the calamitous effects of how long-term care in England is funded have persisted and deteriorated for years now. This is what a new report from the Strategic Society Centre calls the ‘care conundrum’: just why would an organised, politically sophisticated, apparently wealthy society put up with the social care funding system that operates in England?
In Politics and the Care Conundrum, we set out to answer this question. We begin by recognising that if the underlying causes are not money and resources, it must be issues of politics and governance.
So, using a ‘toolbox’ of ideas and theories drawn from political science, we set about exploring those features that result in the ‘care conundrum’ so long observable. What did we find?
In actual fact, there are many factors that drive the ‘care conundrum’. These include: the varied, ʻindefinableʼ nature of social care; the illogical, complex ʻmessʼ of institutions overseeing social care policy; public ignorance of what social care is and what outcomes represent quality; the interests of politicians in avoiding unpopular measures; and, the difficulties of journalists in fitting the many aspects of social care funding problems into a single coherent narrative for readers.
Such observations are not merely academic. Various proposals for reform of public spending on social care have been set out over the last decade, but have not sought to address the underlying causes of this ʻcare conundrumʼ. However, if reforms of care funding are to survive across multiple political and economic cycles, it is vital that these issues are addressed; indeed, it is a prerequisite for a sustainable response.
So if we recognise those features distinct to social care that act as a barrier to reform, how should policymakers respond? We propose an Office for Care and Living; an independent, national body tasked with undertaking various strategic functions around public education, data provision and hold politicians to account.
The precedent for such an institutional ‘fix’ is the Office for Budget Responsibility (OBR). Although producing fiscal projections is the day-to-day job of the OBR, it was ultimately set up in recognition that simple democratic accountability sometimes fails to exert the kind of pressure that results in responsible policymaking.
This is exactly the same dilemma confronting the social care system. The problems of social care funding in England are wholly unnecessary and preventable. Creating a long-term fix will require creating a political fix, so that social care gets the political response it deserves and needs.
James Lloyd is director of the Strategic Society Centre
