As Richard Sloggett recently blogged, despite its prominence on the legislation’s title, social care has very much been the distant partner during the recent debate surrounding the pause in the passage of the Health and Social Care Bill. Monday’s report from the Dilnot Commission will throw social care back into the spotlight.
Established almost a year ago by the Coalition Government, the Dilnot Commission has provided year-long cover to what was one of the most divisive issues of the General Election campaign. Calls from the then Health Secretary Andy Burnham for cross-party talks to resolve the issue rapidly turned into a political mud fight with the publication of the Conservative Party’s ‘Death Tax’ poster which was seen by many as political point scoring against a weakened government.
After 13 years in government, a Royal Commission and the Personal Care at Home Bill, Labour never managed to balance their dream of a National Care Service with the political realities of funding it. The Conservatives fought the election rejecting the notion of a national tax, while at the same time trying to strengthen their own proposals for a voluntary insurance scheme. The Liberal Democrats accused both parties of playing politics but failed to offer any policy solutions beyond a ‘cross-party commission’. The debate proved to be one of the most contentious of the months leading up to the election and is thought to have contaminated the relationship between Andrew Lansley and Norman Lamb, something which may have influenced their recent public disagreements on NHS reform.
Now, as Andrew Dilnot said in yesterday’s Times¸ Monday’s report offers a “once-in-a-lifetime chance to fix” social care in England. However, if you were hoping for a more mature debate than that seen during the election then you could be disappointed.
After years of indecision, stakeholders and charitable organisations are determined to see a government solution delivered rather than further delay and consultation. Carers UK has warned MPs that the country “desperately need a sustainable, well-funded and fair social care system” while Saga have accused the government of “playing pass the time bomb” and ignoring expert advice.
A week ahead of the report’s publication,papers were trailing divisions in the Cabinet over the expected recommendation that the Government should stump up £3billion to fund social care. Cameron and Osborne are said to have reservations about how this will fit with a deficit reduction plan which is already dealing with the cost implications of recent u-turns. This week, the Care Services Minister, Paul Burstow – who is said to be in favour of the report along with his commander-and-chief Nick Clegg – warned that reaction to the report would be “lukewarm” and only the first step towards delivering a viable solution.
Away from the immediate politics, the Government is facing a hostile media waiting with bated breath for another coalition split on a major policy area and any attempt to put more financial pressure on the ever squeezed middle. The heavily trailed proposals for a cap on social care funding have already received thunderous headlines from the Daily Mail, Daily Express and even the Guardian.
Monday’s report could provide the opportunity for all parties to have a sensible debate on the future of social care in Britain. A rapidly ageing population and constrained public finances make the idea of free social care for all an impossibility. Some form of personal contribution is always going to be necessary, but how government and others respond to this will be critical in convincing Britain’s baby boomers.
The extent to which the reported divisions in Government are genuine remains unclear – particularly against a backdrop where the Liberal Democrats are keener than ever to show that their voice is making an impact. Nevertheless, Dilnot will be a test of strengths for the Coalition and the chance to show the partners are truly working together in the national interest. For his part, Ed Miliband has already declared his intention to work constructively on this issue. Is this a genuine offer? Even if it is, will any of the parties be able to face up to the unpalatable political consequences of reform. Increasing taxes or borrowing, or force people to pay more: neither option will seem enticing. Perhaps this time all the parties will conclude that there is less to be lost through consensus than there is to be gained by breaking ranks.