This column has been silent for some months. We had argued for some time that the country was facing a crisis in the funding of social care, but politicians were not tackling it.
A few days ahead of this month’s General Election, candidates in the North Dorset constituency spent several hours at a hustings event in Shaftesbury. Questions ranged over six primary topics. One of these was social care. For some in the audience, it was a relief to find that the four parties represented on the platform all saw social care as a national topic of major concern. That at least is an improvement from the recent past.
Unfortunately, the candidates’ responses did not move us forward from major concern to practicable and immediate solutions.
All seemed to agree that the future lay in some merging of National Health Service and social care budgets. None offered any immediate solution to the fundamental issues; several candidates proposed more funding if their parties were in power, without suggesting how this could be applied to improve the arrangements.
Before you are tempted to push the question down the road by supporting the thought of a national debate on funding social care, please remember that we had one not many years ago, around the recommendations of the independent Dilnot Commission. This was set up by the government of the time in 2010. It reported after a year’s study. The coalition government then took two years to respond, deciding in 2013 to implement watered down versions of Dilnot recommendations but later pushing implementation into the distant future.
This is not the moment to commission a re-run of Dilnot. It is a moment for some decisive action on the funding of those needing care now.
The system is broken. It requires near bankrupt local authorities to fund social care as a statutory responsibility but does not provide them with the financial resources to do so. So council staff spend much of their time wriggling to evade their statutory responsibilities instead of working with providers to discharge those responsibilities. And by default, the management of many people suffering various forms and degrees of dementia is shuffled off onto inadequate social care budgets when it should probably be taking more resources from the NHS budget. Dementia is an illness. The NHS exists to treat illness.
Meanwhile, hospitals find themselves stuck with post-treatment patients occupying costly beds when they should be cared for at home or in residential care more appropriate to their needs, but local authorities are failing to make timely decisions on the funding for sensible arrangements; a unedifying game of pass-the-parcel.
So one cheer for the politicians in allowing this question to reach the agenda this year. But that is not enough. We need answers – now.