Although the Care Bill was included in yesterday Queen's Speech, it's not time for the sector to celebrate. The real issue of how to pay for mounting demand from an ageing population remains unresolved
As expected, the Queen’s Speech included major historic reform of social care law and provisions to implement the Dilnot Commission’s cap on individual care costs, all badged as the Care Bill.
So that’s that for social care funding reform? Well, not quite.
To understand why, look at the response of the Conservative Party to shadow health secretary Andy Burnham's call for a debate on new resources for the care system the day before the Queen's Speech. In a press release headlined 'Labour breathe new life into death tax', Chris Skidmore – a member of the Commons health select committee – slammed Burnham for a supposed attack on hard-working families. This was a note-for-note echo of the Conservatives' now notorious 2010 pre-election ‘death tax’ posters.
Then consider the press release from the Association of Directors of Adult Social Services that appeared the very next day: 'Social care funding - a bleak outlook is getting bleaker.' This showed that £2.68bn will have been taken out of the English care system in the first three years of this Parliament. Some of this has come from what can be termed ‘efficiency savings’ but, as the directors acknowledge, it has also come from reduced levels of care to many elderly or disabled people. Underpinning this is rising demand for services owing to population ageing, and recent research from the Personal Social Services Research Unit provides up-to-date modelling of these costs.
So, in the space of 24 hours, the contours of the care funding debate over the two years to the next election have become clear.
On the one hand, the coalition parties will want to stick to the line that they have ‘fixed’ social care funding, with little remaining apart from a bit of implementation of the ‘capped cost’ model and a lap of honour in the run-up to the 2015 election. To maintain this line, there will be no space for wider debate on the need for significant new resources for the care system over the next decade, or acknowledgement of the unmet need that results from cuts to services now.
On the other hand, the social care sector and Labour Opposition will want to highlight the human effect of cuts to services, and the desperate need for funding reform to inject significant new resources into the care system in the face of age-related rising demand. Whether this is achieved through contributions from people’s estates or one of the myriad other options available needs to be agreed. Of course, none of that is likely to happen without a suitable public debate.
The Conservative Party's press release shows that whatever else the Dilnot Commission on Funding Care achieved, it singularly failed to communicate to the political class the inexorably rising demand for support and the resulting need for tough choices on tax and public spending.
Some stakeholders will also feel the press release shows a callous willingness to take the same shrill, partisan tone on care funding reform that prevented real debate ahead of the last election. It will be intensely depressing for many in social care.
Indeed, it would appear that Conservative Party strategists and some MPs, such as Chris Skidmore, would rather kill debate and score political points, regardless of the consequences for vulnerable individuals trapped in an underfunded system in future. Conservative MPs who actually think some sort of contribution from people’s housing wealth after death is probably a reasonable proposition to keep the care system afloat will keep their mouths shut. (Yes, they do exist. One is called George Osborne who, in freezing inheritance tax thresholds from 2016 to fund the government’s ‘capped cost’ reforms, said in his 2013 Budget report that using inheritance tax in this way was ‘simple and fair’.)
All this puts the social care sector in a hugely awkward position. To make the case for desperately needed resources, it will have to contradict the government message that social care funding is all taken care of. This could nudge care funding out of the ‘good news story’ box of the government’s political strategists and into the ‘smother and ignore’ box. Combine that with growing awareness at the top of government that the ‘capped cost’ reforms will not create an enormous insurance market – a farcical idea from the outset – and the political support for the ‘capped cost’ reforms could drain away. But along with it will go the £1bn promised to the care system from 2016 to fund the Dilnot measures.
The choice for social care and older people’s groups is clear: let the government present social care funding as a good news story success and vote winner, and see the real debate kicked further down the road. Or contradict this line and see social care funding shunted off the agenda again, and with it, some of the new funding earmarked for the system in future.
This story is not over yet.
James Lloyd is director of the Strategic Society Centre
