Do you remember how, during the 2019 General Election PM Johnson lied to us? Of course you do, but the lie that I am particularly referring to is the one about social care.
He told us that he had proposals cut and dried and ready to bring forward. Well it’s getting on for two years now and we still haven’t seen any proposals come forward although there were a whole 9 words about the issue in the Queens Speech earlier this year.
There are two pressures on social care only one of which is recognised. The biggest area is the growing number of the elderly, which leads to an increasing number of frail elderly pensioners.
The second pressure is from the number of people who will live with severe conditions which need social and medical care for the whole of their lives. Caring for some of these people can cost up to £100,000 if we want them to have as fulfilling a life as possible but most have costs which are much below this but still substantial. The only way that this can be provided is by the national taxpayer.
Taxpayers must also be a part of the solution by paying more to fund social care, according to the former Tory health secretary Jeremy Hunt who suggested this should be through a tax rise rather than a national insurance rise that “disproportionately targets” the young. I agree with him. We cannot fund the needs of the elderly by aggressively taking money from young people who already are facing huge housing costs and many have debts from University education that will take them well into middle age to pay off when they will have to start saving for their pensions!
The government is understood to be looking at increasing national insurance rates by at least 1% to fund its plans to fix the long-term funding of the crumbling social care system, with Downing Street recommending a 1% increase, the Treasury 1.25%, and the Health Department 2%.
As Hunt observes “It is a wonderful miracle that we are living longer, but one with dramatic consequences for NHS and care expenditure A 50-year-old man costs the NHS just under £500 on average – but by the time he is 85, that rises to nearly £4,000. Our hospitals will be 40% busier in 15 years’ time, according to one study.”
The Government has made clear that its intentions are not yet clear! No final decision had been taken by the government on how this was to be achieved.
Hunt, who was health secretary between 2012 and 2018 and led on social care policy for his final six months in the role, said a national insurance rise would mean the proposals would be funded primarily by young, working-age people, and instead recommended the imposition of a “health and social care premium”.
The government has said that proposals for a long-term plan to reform the social care system would be set out later this year in response to estimates from Health and Social Service providers that they will require a £10bn boost over the next three years. BUT we have been hearing this for more than 6 years ago. I have just given up the position of Lib Dem lead on health after 6 years. In 2015 one of my first jobs was to go for a meeting with DoH officials to finalise proposals. Six years later we are still waiting.
The sums involved are huge. They need a real funding mechanism and not some fudged nonsense which will tide us over for a couple of years. No more can be squeezed out of Council tax payers because this is a grossly unfair and inequitable way of funding social care so the solution must largely be either tax or NI increases. In their 2019 manifesto, the Tories pledged not to increase the rate of income tax, VAT or national insurance. But that’s their problem not mine!
Whatever proposal comes forward it is likely to include the decade-old report by Dilnot which proposed imposing a lifetime cap on the amount individuals would have to pay for care. The independent commission chaired by the economist Andrew Dilnot suggested £25,000-£50,000 as an appropriate level, but today’s figure could be closer to £100,000.
If many people knew that there was a cap, they could plan for it. The claim from some is that they shouldn’t have to give up their ‘hard earned assets’ which they want to leave to their children. For many of us though our assets are likely to include houses which have grown in value at more than twice the rate of inflation and pensions which we received tax concessions for. I believe it is right that people like Erica and I should use some of our savings to care for ourselves in old age. The kids can have whatever is left. We have already given them a lot of help in a variety of ways in adulthood and still do!
In England, social care is generally not provided free of charge. Typically, only those with savings and assets worth less than £23,250 can get help from their council. There is no overall limit on costs, meaning thousands every year sell their homes to pay for social care. A cap is a much better, and fairer way of providing extra cash for service provision than a long-term sequestration of houses after death.
This is an urgent matter. Changes of this nature take years to work into the system and become fully deliverable. Politicians of all Parties have dodged the bullet on this for at least 30 years since it became clear that the number of elderly people was rising. Bluffer Boris now must deliver on his promises so that we can all plan for the future.