Dementia. Chronic lung disease or arthritis. Loss of mobility, sight, hearing. These are all things that could hit any of us, make us vulnerable and require compassion and social care. The chancellor said his statement on Thursday was about protecting vulnerable people and displaying the value of compassion. So how can a part of that statement have been yet another occasion when social care has been put at the bottom of the list of priorities?
I chaired the commission appointed by the coalition government in 2010 to suggest a way forward. My name was read out in Jeremy Hunt’s statement on Thursday, which breached the 2019 manifesto promise to “fix social care” by delaying the improved funding system I recommended from October 2023 to a (post-general election) date of October 2025.
In September 2021, the then government announced a package of changes to social care funding. There were three main elements. First, an increase in the generosity of the means-tested system, so that instead of needing to be down to your last £23,250 (including property) before you got any help from the state, you would get state help if your assets were worth less than £100,000. Second, a change to the way care is charged for, which would end individual care users subsidising local authorities. And third, a cap on the lifetime amount that you would have to pay, which meant that for the first time ever, the risk of needing social care would be pooled across the whole of society rather than borne by whoever happened to be hit. It would have moved our treatment of people with social care needs closer to the way we deal with medical needs in the NHS.
Since then, hundreds of thousands of families in vulnerable and difficult circumstances have been looking forward to October next year. The announcement on Thursday broke the pledge in the manifesto, and laid out in parliament, and now these families are being told they will have to wait until October 2025. Without these reforms, individuals and families facing the possibility of long social care journeys are left entirely on their own, with the state only helping once their assets – including their homes – have dwindled down to the threshold.
This is not the first time those needing social care have been let down. When Labour came to power in 1997 it pledged to address social care funding reform. There was a royal commission, but nothing happened. The 2010 coalition government set up an independent commission, which I chaired, and which reported in 2011. We recommended reforms similar in structure to those that have now been deferred, albeit with the cap set at a lower level. In 2013, the government legislated, with implementation due in April 2017. Before the 2015 election, the implementation date was brought forward to 2016. Immediately after the 2015 election, it was deferred by a year and then abandoned. Nothing happened.
Then there was a plan for a green paper. Nothing happened. Then there was a plan in the 2017 manifesto, which was abandoned during the campaign. Nothing happened. Then there was another plan for a green paper. Nothing happened. Then Boris Johnson on his first day in office said he had a plan. There was the 2021 announcement, followed by legislation agreed by both houses of parliament and an implementation date of October 2023. Hope grew. If this latest announcement is not reversed, we will again have a whole parliament during which … nothing will have happened.
The way we treat those in need of social care is a strong indicator of how we care about the most vulnerable people. This group has been denied the sharing of risk that we apply most strikingly in the National Health Service, but also through our wider social security system. Just over a year ago, a promise was made to these people by the prime minister. To break that promise now is not only backing out of protecting vulnerable people, but it’s also taking away something on which they were relying.
This is a time for looking to the founding of the modern British welfare state and asking why the principles that apply across so much of it are not applied to social care. In 1943 Winston Churchill said that he and his colleagues were strong partisans of national insurance “for all classes for all purposes from the cradle to the grave”, recognising that social insurance brings “the magic of averages to the rescue of the millions”. That Churchillian insight, shared by William Beveridge and Nye Bevan, is just as true now as it was then, and the glaring omission in our social welfare arrangements is social care. The reforms due to have been implemented next October would have begun to set that right. The delay hurts not only the most vulnerable, but also the carers, formal and informal, who help to support them. Social care is something we have to do together. Making this group wait yet again seems hard to defend. Can we really not do better than this?
Andrew Dilnot is warden of Nuffield College, Oxford, and was chair of the Commission on the Funding of Care and Support