ALEX BRUMMER: As our patchy elderly care system shows the failure of our political class, has no one got the guts to solve this crisis?
Barely a day goes by when we are not reminded of the parlous state of Britain’s system of care for the elderly.
At a time when medical advances mean many are living into deep old age, the finances of local authorities charged with providing it have become ever more precarious.
Former Tory minister Damian Green, a long-time confidant of the Prime Minister, deserves credit for daring to raise the idea of a surcharge to National Insurance contributions to fund the system.
Barely a day goes by when we are not reminded of the parlous state of Britain’s system of care for the elderly
For the question of how to pay for our creaking social care system has become, after Brexit, the most toxic subject in British politics.
It was a major issue in two recent General Election campaigns, and a Green Paper which the Government promised would show the way forward has been delayed many times — with ministers insisting it will be published ‘at the earliest opportunity’.
At the last General Election, the Tories’ campaign was severely damaged by its cack-handed presentation of social care reform plans.
Their proposal meant that only £100,000 of a pensioner’s total wealth, including savings and property, would be protected from long-term care costs.
The plan was branded a ‘dementia tax’ by Labour and embarrassingly withdrawn.
This followed the 2010 General Election campaign when Labour wanted a £20,000 compulsory levy to fund a national care service — they were pilloried by the Tories, who called it a ‘death tax’.
At a time when medical advances mean many are living into deep old age, the finances of local authorities charged with providing it have become ever more precarious
Pressure on the social care system has increased massively as result of the growing number of elderly people and the fact that many care homes have closed (at least 735 since 2016) or been taken over by private equity firms which charge bigger fees.
Among the most serious consequences is that too many people end up in hospital.
They ought to be better cared for — and more comfortable — in their own homes, with visiting carers, or in private or local authority residential care.
In the last year, I, like many of my fellow ‘baby boomers’, have experienced the problem while helping elderly relatives.
First, in a modern residential home in South Wales, I watched compassionate young staff — some locals and others foreign-born — provide loving, 24-hour care to my mother-in-law as she faded away with cancer.
Fortunately, because she had been careful with her finances, she was able to pay her way in a private nursing home.
My other experience of the system, on the South Coast, showed that similar high-quality care can be provided by local authorities.
In this case, the council supplied the money for us to look after my father at home.
Carers would arrive breathless from visits to other patients. The system seemed to be dreadfully overstretched and carers given too many appointments for the hours in the day. But they remained unfailingly professional.
I was almost brought to tears when a young carer who had looked after my father turned up on his 103rd birthday, unannounced, with a bunch of flowers and a card, and sat holding his hand.
The humanity and professionalism of such people impressed me at every turn.
Yet they are struggling to provide the care they should — and want to — because of a deep-seated funding shortage, which is getting worse.
Politicians have been aware of the problem since a Royal Commission on Long-Term Care reported in 1999.
But successive governments — Tory and Labour, including those with big parliamentary majorities — have shown disgraceful cowardice and backed away from reform.
Had Tony Blair, Gordon Brown or David Cameron shown the guts to tackle the issue of long-term care, the crisis that now shames us as a civilised nation and the world’s fifth richest economy might have been solved for good.
If, for instance, ministers in the late Nineties had decided that everyone over the age of, say, 45, should be enrolled automatically in a long- term care-insurance plan — managed in the private sector — we would have had a system that could afford basic provision for the entire country.
And Damian Green himself had the opportunity do something as Work and Pensions Secretary.
Instead, we are left with a patchy, unreliable system that stands as an indictment of the failure of the political class.
Of course, the genuinely poor should always receive free care. But the way the system works is grossly unfair.
It can’t be right that someone who has diligently built up a modest nest egg of more than £23,250 and who may still own their home has to pay out of their savings for care — which, in some cases, can be as much as £1,500 per week.
Yet others who have recklessly frittered away their money and not saved don’t have to pay a penny for their care when they are old.
So what’s the answer to this troubling and deeply inequitable conundrum?
Damian Green’s proposal for a 1 per cent surcharge on National Insurance for people aged over 50 is an admirable start, but doesn’t go far enough.
Former Tory minister Damian Green, a long-time confidant of the Prime Minister, deserves credit for daring to raise the idea of a surcharge to National Insurance contributions to fund the system
I believe that everyone over 40 should be encouraged to pay into a social care insurance scheme.
Until that generation reaches retirement, there would be a transition period in which those over pensionable age could contribute more — either by continuing to pay National Insurance, if still in work, or being means-tested for benefits such as the winter fuel allowance and public transport concessions.
There is a successful model for this in the way that private-sector employees automatically enrol in workplace pensions.
More than ten million are saving into such schemes, which will generate £17 billion of extra savings by 2019-20.
A further possibility, favoured by former Tory pensions minister Baroness Altmann, is for long-term care Isas held by the State, which would offer tax-free investments for people to save for their care.
One thing, though, is absolutely clear: doing nothing is not an option.
The Government is trying to end the system under which central government makes grants to local authorities to cover social care. Instead, it wants councils to raise the money through council tax and business rates.
This is a piecemeal solution and would create further problems. Councils would be spending up to half their revenue on social care by 2035.
Meanwhile, in the private sector, nursing home managers claim they are struggling as a result of factors including having to pay higher wages after former chancellor George Osborne’s introduction of the national living wage.
This is a shabby excuse. The truth is that the private equity cowboys who rode into the care sector in the hope of making big profits have concluded that what once looked like an easy money-making venture is no longer profitable.
As for the Government, we still await its Green Paper on long-term care. Sadly, history suggests that yet again any imaginative ideas will be killed by endless wrangling by politicians who are pathetically too fearful of a backlash at the ballot box to come up with a radical system that works.
Damian Green’s blueprint is a start. But it does nothing to prevent more care homes closing; qualified carers leaving the profession; hospital beds being blocked; and elderly people, who’ve worked hard all their lives, seeing the savings they hoped to leave to their children draining unnecessarily away.
Source: Read Full Article