Further to my column on NHS winter pressures last week, events- in the form of the cabinet reshuffle- have intervened: Jeremy Hunt, the Secretary of State for Health has had Social Care added to his brief. This is an important change.
The problems of the social care sector have had a direct impact on the NHS, adding to the winter pressures. Frail and elderly patients living alone, who -for whatever reason- end up in hospital, are subsequently unable to be safely discharged because there is nobody at home to look after them. This then leads to the clinically unnecessary occupation of a hospital bed.
We are in the front rank of nations where grown up children no longer live with, or close to their elderly parents. In other cultures there is much greater reliance on the family for social care.
In the absence of family, the burden has fallen on local authorities to make provision on a means-tested basis, and the squeeze on their own finances has led to inadequate service levels, the withdrawal of providers, and the closure of care homes.
With the number and the proportion of elderly people growing, this problem has to be addressed by more money, much more.
Ever since I entered Parliament, the key question has been, from where will that money be had ?
We can all pay much higher taxes, or we can share the cost more equitably between taxpayers and those who need the care. There has however, always been outrage at the prospect of asset-rich elderly people having to deplete their savings, sell their homes, or have their homes sold after their death, in order to meet the costs of their care.
A number of schemes have been devised to protect assets by shifting some of the care costs and splitting them between the insurance market and the taxpayer.
Such a scheme, based on the Dilnot Commission findings, was adopted by George Osborne for implementation in 2021 (allowing further time for the public finances to recover).
Unwisely, as it turned out, the Prime Minister changed this policy during the election campaign last summer, and now the issue is to be revisited over the coming months.
I do not share the horror that many fellow politicians have at the prospect of meeting the costs of care from one’s estate, including the principal asset, the home.
As we have made a decision not to expect families to care for their elderly, then families should in turn, not expect to benefit from heritable assets handed on unencumbered.
People should always save for a rainy day (and overwhelmingly the British people have chosen to hold most of their savings in the form of property), well, when you need expensive social care, isn’t that a ‘rainy day’ ?
Why is it that we always expect someone else to pay?