Who pays for care has vexed politicians for decades.
There has been no shortage of good ideas, based on evidence garnered from the
many government reviews and commissions over the years, but there has been a
failure in political will resulting in only limited action being taken.
However demographic change, and its impact, is now an issue that is moving
rapidly up the political agenda. All parties are now signaling a desire for a
long-term, all-party solution to our care crisis. It is clear that now is the
time to take action.
During the debates on the Health and Social Care Bill there was little dissent
from the view that the integration of health and social care is a good thing. In
the Budget debate there was no opposition to the proposal that NHS money should be given to councils to help them integrate services. The recent Dilnot Review was met by a broad coalition of support from a wide range of stakeholders, and was warmly welcomed by all political parties.
Week after week in debates in Parliament failings with today's provision are highlighted. The prospects of finding a long-term solution to the funding of long term care is better now than at any time in the past fifty years.
Who pays for care is just one of the questions the Government's reforms of
social care must address. There are issues of quality, regulation, training and
pay as well as choice. It is vital to ensure that care and health services work
closely together, and that our care laws are simplified to make it easier for
people to get the help they need.
We must never forget that informal carers provide more support than any
government could afford to pay for. The most recent research from the charity
Carers UK estimates that there are more than six million carers in the UK. The
care and support they provide to help people remain safely in their own homes is
valued at a staggering £119bn per year, which is far more than the annual cost
of all aspects of the NHS. Support to enable carers must be central to future
provision of services.
The Dilnot Review came up with a package of reforms that will require an extra
£1.7 bn a year that would rise with an aging population. To set this sum in
context; it represents 0.25% of government spending.
While I do not underestimate how difficult it will be to find this sum during
this Parliament, constructive ideas have been given to the Treasury as to how
this spending commitment could be achieved.
Consideration could be given to sourcing this sum from within government
departments. The NHS has already earmarked £1bn a year from its £100bn-plus
budget by 2014 to boost services which overlap with social care. In parts of
England where services have been integrated, patient care has improved and
savings have been made as fewer people needed expensive hospital treatment.
Alternatives include, £3bn a year being raised through people who work past the
normal retirement age paying national insurance contributions or through an
across the board rise of 0.25% in contributions.
The Government has committed to produce a White Paper by Easter and this week I spent my time at the Conservative Party Conference working with the many people who are playing an important role in building momentum and consensus for
vitally important change.