After hot air, cruelty and neglect... at last my plan is in action

From Britain’s foremost experts on the care debate, two very different views

This brings the care system into the embrace of the welfare state

MORE than ten years ago, the independent commission I chaired published its report into the funding of our social care system.

We concluded that the existing framework was not fit for purpose and root-and-branch reform was required to make it fair and sustainable.

While a great deal of hot air has been expended on the topic in the intervening years, my report’s findings have been gathering dust ever since.

So when Boris Johnson rose to unveil his plan for the future of social care in the House of Commons yesterday I was more invested in the matter than most.

And by the time he sat down, my overwhelming feeling was not so much one of pleasure that the commission’s report had been belatedly implemented, but relief that this country may finally get the care system it deserves.

And a great deal of credit for this development must go to the Mail, which has fought long and hard for a fairer system through its mouldbreaking campaigning on the subject. After all, the recent history of the social care system has been one of capriciousness and neglect.

In a sector gripped by a mood of deepening crisis, inconsistent standards are fuelled by a chronic lack of resources, low rates of pay, and high staff turnover.

Furthermore, the current funding mechanism is both inadequate and unjust. While it fails to provide sufficient levels of cash to meet the needs of Britain’s elderly population, it also imposes unpredictable and catastrophic bills on some families, who, through nothing more than bad luck, face having to sell all their assets to meet the costs of care.

This is not the way a civilised society should operate. No area of civic life is more ripe for reform than social care, yet for decades, politicians have ducked the challenge, indulging in empty rhetoric about the need for change but avoiding tough decisions.

This paralysis has continued despite a deluge of reports from campaigners, think-tanks, select committees and official commissions, including – of course – my own. Our recommendations, which included a cap on care bills, were even passed into law in 2013 – but David Cameron’s coalition government baulked at enacting them after deciding that, at a time of austerity, they were too ‘expensive’.

Indeed, given the political climate of caution, I privately said at the time that my commission’s proposals had only a one in three chance of being implemented.

But suddenly, the landscape has been transformed. Hesitancy has given way to action.

Striding into territory where so many of their predecessors feared to tread, the Government yesterday set out a comprehensive plan for reform. The move was the fulfilment of a pledge made in Mr Johnson’s very first speech on the steps of Downing Street in July 2019, when he said that he would ‘fix the social care crisis once and for all’.

He is now taking action. Under his scheme, national insurance will rise by 1.25 percentage points – for both employers and employees – ultimately providing over £12billion a year for the NHS and social care.

At the same time, the iniquity of forcing householders to sell their homes to pay for care will be ended by the introduction of an £86,000 lifetime cap on care payments.

Meanwhile, anyone with assets worth less than £100,000 will receive help from the state with their bills down to a threshold of £20,000 in savings, below which all care will be free.

This is a sensible package that finally brings the care system into the embrace of the welfare state – where it should have always been.

The arbitrary cruelty of hammering some unfortunate households will be replaced by a new approach under which the state enables the risk of people requiring support in the twilight of their days to be pooled across the population.

Inevitably, perhaps, given the sensitivity of this issue, there have been protests. But much of this criticism is misplaced.

Some complain that through the hike in national insurance, the Government is imposing a heavy new burden on the working population in order to protect the inheritances of the wealthy.

But the reality is that everyone, including current generations of workers, will benefit from a properly funded, well-run care system, just as everyone gains from the NHS or free education.

Moreover, the new levy is broadly progressive in its application, with the wealthiest paying the most, while those on lower incomes are protected, and with the poorest

paying nothing at all. That egalitarian principle comes through in the way the lifetime payments cap works with the means test. All care spending – not just by the individual but also by the state – will count towards the £86,000 limit.

In practice, therefore, a resident who has half their costs met by the local authority under the means test will reach the cap having spent just £43,000, so far less of the family’s savings are lost.

There is also sense in the decision to extend the 1.25 per cent insurance levy to pensioners who are in work or who have an income from dividends, ensuring that affluent pensioners make a contribution to the tax increase.

There are still concerns to be addressed. The existing meanstested system is under enormous pressure, and will need more funds in the short term to keep it afloat and maintain its ability to care for the least well-off and most vulnerable.

And the NHS has a voracious appetite for funds, so the competition between health and social care will continue – and needs to be closely monitored. This issue will need to be resolved in the spending review this autumn.

But as I said, I once gave our commission’s proposals only a one in three chance of being implemented.

Today, I’m very pleased to say, I was far too pessimistic.