As the Tory leadership race approaches the final straight, candidates have been putting forward the policy platforms they would take into Government. Among eye-catching tax cutting proposals, both Jeremy Hunt and Boris Johnson have named solving the social care crisis as their immediate priorities in No.10.
The public has started to notice support for their relatives dwindling, with hard-pressed family carers filling MPs’ postbags with their concerns. Two thirds of MPs in a recent survey said they had constituents’ social care-related queries increase, with half seeing a “significant” increase in the volume of complaints. Now a cross-party House of Lords Economic Affairs Committee report has highlighted the challenges facing the system.
But despite broad recognition that there is a social care crisis, policymakers are no nearer to agreeing how to solve it than they were twenty years ago. Since the 1999 Royal Commission, there have been 12 White Papers, Green Papers and assorted consultations on long term social care funding suggesting ways to break the impasse. It appeared that a breakthrough had been made when Andrew Dilnot’s proposed care cost cap was accepted by the Coalition Government, but this was then shelved in 2016.
Theresa May’s administration promised a Social Care Green Paper during the March 2017 Budget but over two years later it is still yet to be published. It has been repeatedly delayed, the victim of the ongoing Brexit negotiations, ministerial changes and, most importantly, a Treasury unwilling to sanction another major spending pledge after a tough negotiation with Simon Stevens over the funding of the Long Term Plan.
And now, with a new Prime Minister expected to be in post just as Parliament rises for the Summer, and potentially other changes around the Cabinet table, the Green Paper faces further delay. Experts and third sector groups fear it will be abandoned altogether.
Various politicians have tried to fill the vacuum. Former Cabinet Minister Damian Green, originally tasked with delivering the Green Paper, called for a universal entitlement, while Jacob Rees-Mogg made the case for an annual cap of £5,000 per year. Leadership candidate Hunt has revived the idea of a Dilnot-style cap but still wants to encourage people to save into a social care fund alongside their pension, while Johnson has called for a cross-party plan and more funding to resolve the issue.
Whoever the victor of the leadership contest, the next Prime Minister cannot ignore the social care crisis
Yet progress continues to stall because there is no consensus over who should pay for social care. The Conservatives remain nervous about measures like inheritance tax targeted at older voters. Labour, who are publicly wedded to a cap on costs but flirting with the idea of a system of free personal care, remain tight-lipped about which of the funding options from its 2017 manifesto it would choose; either a wealth tax, an employer care contribution or a social care levy. Whoever the victor of the leadership contest, the next Prime Minister cannot ignore the social care crisis, and some tough choices will need to be made in order to fund a solution.
All the while, the pressure to find a resolution continues to grow. With one eye fixed firmly on his own legacy, Simon Stevens may ratchet up the pressure on the new Prime Minister to solve the social care crisis once and for all – the success of his Long Term Plan and integrated care depends on it. Certainly, social care policy is set to be a major theme in the next 12 months. Now more than ever healthcare innovators and partners need to determine how these changes could affect their work with the health and care system.
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