The triple lock was introduced in 2010 by David Cameron’s Coalition Government when Steve Webb (Lib Dem) was Minister of Pensions, to restore the erosion which had taken place since the earnings link was replaced with a prices’ link in the 1980s. To replace the triple lock with a prices’ link or 2.5%, as was proposed today, will reverse the progress of the last sixteen years. Clearly it has been proposed to save money, as it was in the 1980s, which means a reducing state pension at the very time Government should have been looking to increase it to reduce demand upon the NHS and social care. It is not just about paying for social care.

Prices are about the cost of living. Earnings are about the standard of living and quality of life. As the economy grows so too do the expectations and necessities of life. For example in the 1950s very few people had a fridge: it would be difficult to live without one today. In the ten years before the introduction of the triple lock in 2010 earnings went up by 41.7%, pensions linked to RPI by 32.4% and those linked to CPI (as now proposed) by 26.6%.

There is a wealth of empirical evidence into the social determinants of health which has demonstrated the correlation between low income and health. Widening income inequality and increasing poverty are the root cause of so many of the problems the Prime Minister was addressing in his speech to the Labour Party Conference.

In 1980 the average house was 3.5 times average earnings and the average pay of a chief executive of a top hundred company 18 times average earnings. In 2026 the average house is 8.5 times average earnings and the average pay of a chief executive of a top hundred company 186 times average earnings. Unless Government addresses the widening income inequality and increasing poverty in our society the NHS will not keep pace with demand and will always be playing catch up. Governments cannot go on throwing more money at the first aid camp at the bottom of the cliff without building a fence at the top. Treating the symptoms not the cause.

Britain has one of the lowest State Pensions in the developed world with 2.4m older people living in poverty. Older people got no benefit from the two pre-2024 General Election cuts in National Insurance, previously lost their free television licence and some their winter fuel allowance and have to pay more income tax due to the freezing of the tax-free allowance. And are now to see a year-on-year erosion of their pension.

Older people account for approximately 70% of the expenditure of the NHS. To raise the State Pension to lift all older people out of poverty would improve their quality of life, reduce demand upon the NHS (saving huge amounts of money) and mean that if they did need long term care in a care home applying the same financial assessment which has been in place since the 1948 National Assistance Act they would be able to contribute more reducing the cost to local authorities and mean that their capital and house would no longer need to be taken into account.

The NHS and social care need radical reform, restructuring and cultural change based upon a whole systems approach to liberate the hardworking professionals from the constraining contract culture into an enabling leadership one. Taking out functional divisions along patient / user pathways to create “whole task, right sized, multidisciplinary, inter-agency teams”, able to “plan do and evaluate* their own work which completes the learning cycle of constant improvement.

A survey by The Times found there were on average 13,600 people a day in hospital awaiting social care. To enter a care home is one of the few irreversible decisions in life and is not to be taken lightly or without an assessment of need and verification of wishes. And there are many more older people not receiving the help they need in the community.

Social care needs to move from a “minding” to a “mending” service. Social Work is under-valued and social workers misused.

Past deliberations have focussed on paying for social care. If the emphasis were to shift to where best to intervene and put the money Government may find they do not need as much as they thought.

This is covered in much greater depth and costed in my book.

Click the picture below for an over view and executive summary.

* Chris Perry is a former Director of Social Services for South Glamorgan County Council, a former Director of Age Concern Hampshire, a former Non-Executive Director of the Winchester and Eastleigh Healthcare NHS Trust and a former presenter of an award-winning public affairs programme on Express FM.