29th July 2020
At the start of each session MPs are frequently asked “What are your priorities for the coming parliament”? Setting aside the local issues that vary from constituency to constituency, housing is usually high on the agenda as is Education, Brexit and our international relationships and personal interests – in my case animal welfare. For some time, however, listed Health and Social Care as the number one concern with a growing emphasis on the social care piece of that jigsaw.
I note with interest, therefore, that Age UK has now mounted a petition, signed already by tens of thousands of people, calling for a “new social care system that is free, fair and available to everyone when they need it”. That is, of course, a requirement that few if any would quarrel with. The real question, though, is not what we want but how it is going to be achieved and paid for and it is in that minefield that many good ideas that have been floated have foundered.
Age UK`s “Joined up health and care services” are, as the Covid 19 pandemic has reminded us if we ever needed reminding, essential. Without a joined up approach people will fall through the net or be discharged from hospital into nursing or residential homes, as indeed they have been, to potentially spread disease. `Joining up` ought to be more efficient and therefore cost less, not more, taxpayer`s money. From there on in, though, we are looking at Big Ticket items.
“An increase in support for unpaid carers” is highly desirable. We all know of people looking after husbands, wives, relatives or even just friends who are themselves desperately in need of some back up and respite care. That resource has to be paid for as does “Support for working age, sick and disabled people as well as older people” and particularly “investment in care workers to ensure high quality care”.
In fact , the latter is Government policy. The Home office and Health Department response to the concerns that I have raised about a looming shortage of hospital ancillary staff, nurses and care workers arising from the much-vaunted `points based immigration system` is that we shall invest in the training of home-grown staff who will, of course, earn much more than the current living wage to make the job attractive. I know enough about residential and nursing homes in my constituency to understand that they are operating at the margins now: if we increase costs then that money is going to have to come from somewhere and the County Council`s Social Services budget is already under stress. There are those, of course, who believe that all of this care should be nationalised but the thought of ending your days in a neo-soviet geriatric Gulag might just not appeal to a majority of those needing care services .
The Age UK`s petition`s call is that all of their proposed largesse should be `funded through taxation` as indeed, up to point of course, it already is. I fear, however, that the accumulated debt arising from the cost of Covid 19 is going to occupy the minds of several Chancellors of the Exchequer for many years to come and while increases in taxation there will certainly be there will not be much slack left to put more money into social care in the short to mid-term . We must not place an intolerable burden of taxation upon today`s working population.
We need, therefore, a current and a long-term solution. The current solution, whether we like it or not, is going to have to rely more upon individual personal funding while `fairly` – one of the buzz-words of the Age UK campaign – still allowing those who have worked and saved throughout their lives to hand on at least a reasonable proportion of the fruits of their hard work.
The long-term requirement will have to be that from day one in employment there is a ring-fenced deduction that on an actuarial basis will pay for care in disability and/or old age. We have always shied away from what is called hypothecated taxation in favour of a central fund from which the Exchequer pays for its political priorities. I do not think, though, that we can any longer just rely upon people to buy the insurance that they think they may require while expecting today`s taxpayers to fund the rest. Until now `National Insurance` has never been that at all; it is simply taxation under another name that helps to fund, amongst many other things, health and social care. Building up pension funds through statutory provision will help to see people through retirement but is never going to sustain a person through possibly lengthy infirmity in old age.
Theresa May`s 2017 Conservative election manifesto, a document that arguably led to her downfall, contained serious proposals to begin to address the issue and generated a backlash of media hysteria that reverberated throughout the disastrous campaign. Sooner rather than later, though, this is a nettle that has to be grasped. At present today`s diminishing number of working taxpayers are funding the care of today`s growing elderly and non-working population. We have to move to a situation where, instead, todays working people pay for their own care in later life and while that provision takes time to mature we shall have to bridge the gap by still requiring those that have the resources to pay to do so. That will not, as Mrs May discovered, be popular but given the economic backlash resulting from the pandemic it is, I believe, a measure that a Conservative government with a large majority should be bold enough to take.