Progress | Centre-left Labour politics

The truth about elder care

For decades successive governments have let down older people. And yes, that does include Labour governments. Because there is this myth that when you got older the state will look after you. After all, the NHS protects us with free care from the cradle to the grave, doesn’t it?  Except it isn’t really true. Well, it is if you die having never needed any social care – help to get by at home or residential care. Then it is perfectly possible that you may go to your grave protected by the ‘free at the point of need’ NHS. And for one-in-four people over 65 this is pretty much the case, and the myth is for all intents and purposes true. But for the other three-in-four it certainly isn’t true at all. Two-out-of-four will face bills of up to £20,000 for their social care before they die and one-in-ten will face bills of over £100,000. For them the myth is quickly shown to be a cruel, cruel lie. Savings are used; family homes sold and children need to help. After a life of toil your reward is potentially poverty and letdown.

Politicians have chosen not to deal with the myth; you could say that their silence has verged on being a lie. The problem is that it isn’t in anyone’s interest to sort this out. Which politician wants to be the one that finally admits to the myth being a myth?  Will they be thanked for their honesty?  No, they will be blamed. And the public, you and me, don’t want to think about being old and frail. Infirmity happens to other people – a bit like lung cancer and smokers. So we bury our heads and choose to believe the myth. Which is why Labour had reports commissioned on the issue and then buried the conclusions. It’s why the Tories have done the same thing this year with the Dilnot Commission on funding of care and support. The inertia has kind-of suited us all, well unless you or a relative becomes infirm and frail.

But the reality is that the NHS pays for your healthcare needs. It clearly does not pay for your housing, food, heating or personal care like shopping, cooking or personal hygiene. So if you have an accident and end up in hospital you will be treated for free and then discharged. All well and good unless you have a residual disability that means that you need some continuing help with social care at home or need the support of residential care. In which case you will pay for this yourself if you have assets of more than £23,500.  With home help at £10 – £20 per hour and nursing homes at over £30,000 per year those savings don’t last long. And silently every day of every week of every year thousands and thousands of people and their families are suffering the fear and stress that this can bring. It’s the ‘squeezed middle’ again: if you’re very poor the state will pay, if you are rich you can afford to pay. But for the rest it is likely to be a nightmare.

In July the Dilnot Commission recommended a partnership between the state and the individual so that we each know what we will have to pay and what the state will agree to pay in the event that any one of us needs social care. The amount that an individual will have to pay will be capped at £25,000 – £35,000 before they die plus accommodation costs. The state will pick up the tab for the rest. It will mean that people will still have to use up some of their assets to pay their share – but for most people, not all of them. It will mean that the state will have to pay a bit more but its liability will also be limited. But it will need the myth that it’s all free to be dealt with. It certainly won’t be instantly popular!

So Labour is right to be pushing for cross-party talks on the issue. Liz Kendall MP in particular deserves a special mention for her tireless campaigning on this issue. There have also been some encouraging noises from the government. If ever there was an issue that needed the politics taking out then this is it, it will only happen if the major parties choose to work together, agree a solution and so share the political backlash. It is the right thing to do. But the chances of it being kicked once again into the long grass are high after all we managed on this for 13 years. Fingers crossed.


Peter Watt is a former general secretary of the Labour party


Photo: Building Construction Partnership

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Peter Watt

is a former general secretary of the Labour party


  • Here here to Peter Watt. I could not agree more. How to provide care for the growing numbers of older people in innovative and imaginative ways is the greatest challenge we face as a society. The remuneration levels of care workers in residential and nursing homes has got to be tackled. To be paid the mimimum wage for such complex and demanding work is a national scandal. I’m fully behind Andrew Dilnot and Liz Kendall deserves our full support. This is not just a mission; this is a crusade for quality and fair care. Anne Marie Rafferty, London

  • How can it be possible to take politics out of something that is so fundamentally about fairness and redistribution and should be at the heart of what Labour does and stands Tory government will ever deal with this issue.

  • So of course the answer should be that nobody works for a min wage but gets a decent wage, but of course with labour saying now wages will not go up in the public sector the simple question is ,who are Labour talking about here the loved middle class, because they seem never to talk about people who need the help the most.

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