Theresa May created many problems for herself in this year’s snap election. Some are rather difficult to ignore, like fewer MPs and no Conservative majority. Others are very tempting and advantageous to ignore, like social care. The botched manifesto proposal on the long-term funding of social care has made reform even less attractive to politicians who were already minded to set up as many independent reviews and commissions as possible in order to avoid telling the public that this is going to cost a lot of money to fix.
Meanwhile the sector is even more on its knees than it was before. Crises don’t get better just because politicians ignore them. A poll of 101 MPs published last week by charity Independent Age found that nine in 10 don’t think the current system is fit for purpose.
The government does still plan to publish a green paper on long-term funding of social care, but given governments have been publishing green papers on this matter for rather a long time, this doesn’t mean that even a cogent proposal on funding will then have much prospect of being implemented any time soon. Sarah Wollaston is the chair of the Health Select Committee, and insists that ‘we now need to just get on with it. Within the green paper there needs to be a timeline of exactly what is going to happen and when.’ Wollaston points out that there are already sufficient options which experts have developed for the government over the years for ministers to choose from – and the sector has responded to so many consultations on the matter that it is difficult for anyone to claim that they still don’t know what social care professionals think.
One of the problems with social care is that it falls between two departments, both of which already have serious policy challenges elsewhere. The Communities and Local Government department will always be focused on trying to get more homes built – and is additionally occupied with its response to the Grenfell disaster – and the Health department has its own problems with long-term financial sustainability in the NHS to worry about. To try to overcome this, Damian Green has now been tasked with leading the social care reforms as second-in-command to Theresa May.
Green will need to get the various sides in the political debate around social care talking to one another. It is such a big reform that the three main parties representing English constituencies do need to be supportive of the overall principle, even if they are critical of some of the details. This is where it gets almost as difficult as the prospect of squaring the additional cost with the electorate. A number of Labour frontbenchers just do not trust the Conservatives after they turned on Andy Burnham’s 2009 proposals for reform, labelling them a ‘death tax’, having previously indicated support. The Tories might argue that Labour got its revenge in the snap election this year when it turned on May’s ‘dementia tax’. Either way, cross-party working isn’t currently happening, and the various parties are blaming one another.
Barbara Keeley is the frontbench lead for Labour on social care. Her colleagues say she doesn’t want to help the Conservatives at all on social care, and is still stung by Burnham’s experience in working with them. But she insists that the problem is that the Tories just aren’t open to talks. ‘We are getting on with Labour’s plan, we have always said we will talk to whoever,’ she says. ‘But there is no willingness on the part of Jeremy Hunt and his team to talk to anyone. I think we could move on now from where we expressed our positions in our manifesto.’
Labour’s Shadow Secretary of State for Health is Jon Ashworth. He is similarly impatient for cross-party talks. ‘It’s going to be expensive, but the government has got to grasp the nettle of putting the money in,’ he says. ‘When we were in government, both Labour and the Tories had to cross a difficult rubicon on pensions reform: our leadership found the earnings link difficult and the Tories found auto-enrolment difficult but we managed it. Now the whole thing seems very uncontroversial but it is possible to get a solution on a thorny public policy issue.’
Before the summer, former Liberal Democrat care minister Norman Lamb had been mooted as someone who Number 10 could use as an external cross-party lead on social care. He is now waiting to see what the government’s next move on this is, and also hopes that there are sufficient numbers of Tory and Labour backbenchers who are worried about social care that Parliamentary pressure for real reform could develop quite quickly. ‘I’ve again put the case to Number 10 to engage with this process,’ he says. ‘On the face of it, there appears to be widespread support for it in Parliament and there is a lot of support on the Tory benches too.’
The problem is that even if everyone recognises that something really has to be done quite soon, those who need to drive the reforms, including Number 10 advisers and Damian Green, could also quite feasibly struggle to find the time and energy to embark on one of the most difficult and complex domestic reforms while also working on one of the most difficult and complex negotiations that Britain has had to make as it tries to leave the European Union. Currently, everyone in the social care debate is holding their breath. But it’s probably wise if they don’t hold it for too long.