Seeking a social care consensus

Labour will enhance, not damage, its position, by seeking a consensus on social care funding – Read Caroline Flint’s speech at Progress’ cross-party social care event

Thank you Progress for hosting this timely and important discussion.

It is now over a year since I and Liz Kendall started working with Norman to advance the argument for an independent national commission to bring forward recommendations for a long term solution to the social care crisis. Forgive me if I address my comments very deliberately at my Labour colleagues and my party about why we should support that approach.

I want to mention three aspects of this debate: the politics of health in the Labour party, the matter of trust – and the related issue of paying for social care long term. And then the offer and how that meets individual choice and lifestyle.

First, the politics of health. On Saturday I was out with activists petitioning residents as part of Labour’s care for the NHS campaign. Labour and the NHS go together like bread and jam. We’re proud of our role in creating and then modernising the NHS. But our party has used the health issue in two ways in recent years:

First, by attacking Tory mismanagement and promoting the notion that they have a covert privatisation agenda, we avoid dealing with any real choices about where the service goes in the coming decades.

Is the NHS under pressure – undoubtedly. Are trusts in debt – yes most are?  But are NHS hospitals about to be sold off to Virgin or Tesco? I don’t see the evidence; but for the last five years at least, that appears to be Labour’s underlying accusation directed at the government.

Second, when our party slumps in popularity, we focus on the NHS even more, as a safe issue which our voters understand.

So let’s go back to last Saturday – 95% of people signed the petition demanding the government increase funding for the NHS. A few thought we were raising funds and offered a donation. We didn’t accept. But only half the people we met were Labour voters. Remarkably lots of people signed but then declared they don’t vote in elections.

The problem is that on its own the NHS cannot win Labour elections. It doesn’t harm our prospects; but it didn’t win the election for us in 1997, 2001 or 2005. And it couldn’t save us in 2010 or 2015, when we asked activists to tweet “24 hours to save the NHS”. And in the last decade, the economy and immigration have been far more important to voters.

If the desire is to build a party advantage the incentive is to attack; and not to build consensus.

We are right to hold the government to account over the NHS. But whatever government was in power there would be big questions concerning the enormous long term investment required for social care that remain unresolved. I believe when it comes to social care our party will enhance its position, not damage it, if we seek a consensus on how it is funded and what it should offer.

Labour isn’t the only guilty party.

In 2010, when Labour proposed a £20,000 contribution for social care, paid after, not before the care was delivered, the Tories produced this poster. ‘R.I.P. off. Now Gordon wants £20,000 when you die. Don’t vote for Labour’s new death tax.’ Even in his budget Speech today the chancellor raised the spectre of Labour’s so called “death tax”.

We cannot forge a solution if every proposal is met with this kind of partisan attack.

Today’s budget doesn’t end the social care problem.

Social care spending this year was £14.4bn in England. That figure had fallen by nine per cent from 2010-15. The number of pensioners offered Local Authority contracted social care fell by a quarter from 2010-15. The King’s Fund says that social care faces a £2.3bn funding shortfall in 2017-18, which today’s £1bn for next year plus council’s social care precept will only halve.

And even as funding increases, rises in the national living wage also affects social care costs in future years – as most workers in the sector are on minimum wage.

Second, the issue of trust.

We are living through an era of cynicism, and mistrust. Social media and anti-establishment parties, all contribute to a climate that is not conducive to good informed debate. And if public trust in politicians is low, then willingness to vote for policies that have a price tag attached diminishes. So, instinctively, older voters are going to be guarded, wanting to keep their savings, rather than pay towards a government programme. This is made more complicated by the natural desire of ordinary voters to leave a legacy for their children, maybe even before they die.

The current system leaves families that are above the threshold for state support, effectively mortgaging their parents’ home to pay for perhaps 18 months or two years of care. People have to be assured that any contribution is seen to be fair and not punitive. But this also relates to my third and final point.

We all have an image of what residential care is like. All the rooms the same, the food is regimented. A TV in the communal area is on too loud; and someone is doing a half-finished jigsaw in the corner. Maybe that is unfair – but it is a common perception. A future where older people just accept this offer is unlikely.

The sector has evolved in the last two decades, but the UK is way behind places like Holland in offering residential care and home care that meets the class and cultural expectations of residents. If in my life, I like scandi thrillers and thai food – why should I want less than this when I cannot provide the care myself?

I see too often a somewhat patronising approach to the care of older people that I don’t like and wouldn’t want for myself, family or friends.

Those services that support independence, with a diverse menu of care or activity which people can opt into only if they want, are in a minority of the care services on offer.

Personal budgets are talked about a lot but is everyone empowered to take advantage of that and what choice is there?

I suspect that people will not agree to a social care tax or charge for social care, if they do not trust what the quality of the offer is; and whether it suits their expectations for their later years. Perhaps, even if it is short-sighted, they may choose the option that allows them to keep control of their money and assets even though this may not be in their best long term interests.

For all these reasons and more we should seek a new consensus beyond the politics of attack. We have to restore trust by establishing a fair contributory system to social care cost. This is probably best established independently of the major parties.

But to appeal, the care offer must be credible, flexible and meet the lifestyle and expectations of this generation of older people.

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Caroline Flint is member of parliament for Don Valley. She tweets at @CarolineFlintMP

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