The Independent View: Social care and the Dilnot Commission

Last year’s Liberal Democrat manifesto promised that “We will establish an independent commission, with cross-party support, to develop proposals for long-term care of the elderly.” The new Government took swift action on this manifesto call, setting up an independent commission chaired by Andrew Dilnot in July last year. This week, the Commission on the Funding of Care and Support will present its recommendations on how social care funding can be reformed to ensure a sustainable and affordable care system for the future.

Age UK’s recent report, Care in Crisis, highlighted the serious issues plaguing our care system. At present, of the two million older people in England with care-related needs, 800,000 receive no formal support from public or private sector agencies. The extra £2bn for social care provided in the Comprehensive Spending Review was balanced by general reductions in central Government grants to councils, with our recent evidence showing that there have been cutbacks to care services in most English councils.

Our projections suggest that local authority budget cuts will reduce spending on older people’s care by £300 million over four years, leading to nearly one million people in need of care being left out of the system. Councils face bleak choices in determining where their diminishing social care budgets go; some are increasing or making new charges on social care provision, while others are reducing personal budgets or domiciliary care packages or reducing the number of placements in care homes.

The real test on social care facing this Government, and particularly Paul Burstow as Care Services Minister, is whether it will commit to publishing a White Paper on care this autumn. Any such White Paper should encapsulate the recommendations of the Dilnot Commission on social care funding and also the recent Law Commission recommendations on changes to adult social care legislation. Furthermore, it must lay out clearly how its new proposals will be funded.

Social care is badly in need of reform, but sustainable long-term change in this area demands a cross-party consensus on the direction of travel. In a Channel 4 debate last year, the Liberal Democrats’ Norman Lamb and Labour’s Andy Burnham committed to working together to find a solution for social care funding, while Andrew Lansley declined the offer.

Liberal Democrats have an advantage in leading social care reform, with current party policy backing it. The party’s last comprehensive health and care policy paper, Empowerment, Fairness and Quality in Healthcare, endorsed several key principles for social care reform back in 2008, and much of it is still relevant and badly needed. The paper acknowledged the low levels of spending increases for social care compared to the NHS and stated that more must be spent for social care. It outlined the belief that personal care funding must be shared between the state and individuals, a sentiment likely to be expressed in Dilnot’s recommendations next week. It also laid out some key principles which Age UK would endorse in a future care system, including:

  • Fairness in the allocation of funding and the way it is raised
  • A sustainable system, bearing in mind the ageing population and more people living with disabilities or long-term conditions
  • A system that promotes dignity and independence
  • Avoiding disincentives to save for later life

Paul Burstow as Care Services Minister and the Liberal Democrats face both a challenge and an opportunity; showing leadership and working effectively with Government and Opposition parties will require significant time and investment, but leading reform that puts social care on a more sustainable footing for the future will be a bold political legacy.

Ruthe Isden is Age UK’s Programme Manager for Public Services and is also on the Executive Committee of Women Liberal Democrats.

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This entry was posted in The Independent View.

One Comment

  • David Rogers 4th Jul '11 - 9:30am

    Ruthe is correct in her final comment, that securing real reform on this issue will be a bold political legacy. There are signs of a political consensus emerging, in that the leader of the opposition has now twice referred to the need for progress to be made on this issue. That supports the overwhelming wish of all parties in local government – at the sharp end of much of this debate – to attain a sustainable, long-term solution; not to mention the efforts of virtually all of those organisations who operate in this sector. That united voice will need to be maintained over the next few months, in the face of whispers of disquiet from certain quarters within the Government.
    Let’s not forget too the vast and increasing numbers of our fellow citizens who currently receive no financial support from taxpayers, and often limited support in the way of information and advice on their choices, towards meeting even relatively modest care needs. Some of those will see almost all their resources, built up over a lifetime, disappear in a few short months or a year or two at best.
    So the issue cannot yet again be shelved. The debate on how best to move forward begins today, with the publication of Andrew Dilnot’s report, and we owe it to this and future generations to secure agreement on a balance between individual and state responsibilities – and then to ensure that Parliament legislates to secure our long-term futures.

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