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Coffee House

Social care reforms: clever politics, bad government

11 February 2013

10:14 AM

11 February 2013

10:14 AM

Judge a Government on its priorities.  And then its priorities within priorities.  Amidst the clamour for rapid and credible deficit reduction, the dawning reality that green shoots won’t sprout unaided, Iain Duncan Smith’s welfare reform and Michael Gove’s education revolution, social care did make the hastily compiled Coalition to-do list. But a Government’s Parliamentary programme is a game of two halves, and within weeks of Andrew Dilnot’s radical report in 2011, it became clear that any such reform would be a second half priority.

Today, after months of cross-party Whitehall wrangling and internal Coalition debate, the Health Secretary proudly unveils the Government’s offer.  A new cap on the total social care costs an individual will have to pay over a lifetime – £75,000 – and a much higher means test threshold, up from the tediously low £23,500 to a rumoured £123,000.

Our airwaves and inboxes are already overrun by care industry specialists, pouring over the details and giving their feedback.  For those who have long-pleaded for bold funding reform, today is bitter-sweet. Something is better than nothing.  At last ministers have made their way to that long grass their predecessors kept kicking to.  But they also know that with such a high cap in place, these are reforms for the few not the many.  Millions will continue to face catastrophic personal social care costs.

What’s true for them is that ‘Dilnot diluted’ is no Dilnot original, but it is palpably better than no Dilnot at all.

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But take a step back.  The social care system is in crisis. It is broken and underfunded. The poorest pensioners – society’s most vulnerable – face sub-standard care.  A two year Centre for Social Justice review took me the length and breadth of the UK to meet many of these older people.  What we uncovered, I believe, should shake our nation and its leaders.

There is a dangerous lack of prevention and early intervention support to help older people stay independent at home. ‘Rationing’ renders many who need care unable to get it.  Numerous care workers are devastatingly demoralised, poorly trained, paid the bare minimum and often leave the sector as quickly as they join it. Local councils undercut and underpay providers leading to sub-standard quality. Flying 15 minute visits short-change people who need help at home.  The Care Quality Commission, the sector’s flagship regulator, checks process more forensically than quality.  The long list of problems goes on.

So, amidst today’s fanfare and pointed debate, ask yourself one simple question.  Which of these pressing failures will be reversed by the Coalition’s multi-billion pound ‘investment’? The unavoidable answer is none.  Not a single, shameful one.

Many dedicated but drowning professionals delivering care on the front line can think of countless flaws in need of attention and investment.  Protecting housing wealth might be on the list, but much further down.  Perhaps there is a case for implementing Dilnot-style reforms.  But first, it is our duty to protect those who cannot protect themselves.

This is clever politics, bad government.

Christian Guy is Managing Director at the Centre for Social Justice.

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