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In the absence of any mention whatsoever from the Chancellor in his autumn statement of a social care crisis of biblical proportions, it was down to Communities Secretary Sajid Javid to come up with something to make it look like the government was taking the issue seriously. A tall order, and one he was surely capable of rising to. But in the end he obviously thought “Bugger it! I’ll just use the same trick that didn’t work last year either. Hopefully no one will notice”.
Javid’s announcement last week that he will allow local authorities to increase the council tax precept to 3% to cover the ever widening hole in the social care budgets was far too little far too late. This plan amounts to little more than rearranging the furniture on a sinking ship, as a looming crisis in social care, predicted for years by experts across the political divides, starts to do a lot more than loom.
Councils, responsible for proving social care, but hobbled by rules brought in by the coalition to prevent local tax rises above 2% without an expensive referendum, were allowed last year to add an additional 2% for four years, as long as it was ringfenced. Now they’re being given the option to increase it by 3% over the next 2 years.
Those of you with a basic grasp of arithmetic will have spotted the flaw in this cunning plan. It adds nothing to the overall pot and merely allows the original 6% that would have been charged over the next 3 years to be charged over the next two. But that didn’t stop the Tory snake oil salesman from claiming that along with an additional £240m from central government the government will be providing a £900m funding uplift to the social care fund.
That sounds like a lot until you consider the funding shortfall that councils will actually face by 2020 is anything from £2.6bn to £5.8bn depending on who you talk to. Javid’s plan seems to suggest a realisation of the growing urgency for funds, yet just puts off dealing with the problem for perhaps another year at best. It’s little more than a sticking plaster on a gaping wound that has been festering for a generation. What he’ll do in 2 years time when this little wheeze is exhausted is anyone’s guess. Maybe he’ll pull another couple of billion out from behind Philip Hammond’s ear during his budget speech next year.
It’s a plan that has been condemned by Labour, notably in an uncharacteristically animated attack from Jeremy Corbyn during PMQs this week when he reminded a seemingly uninformed Theresa May of the extent of cuts that her government had imposed on local councils whilst she simultaneously sanctioned corporation tax cuts amounting to almost the same amount missing from the social care budget.
Yet Labour, along with successive governments of all flavours have failed to deal with the impending catastrophe even when they were in power. In a similar way to how we’ve dealt with the threat of climate change, we allow cognitive dissonance to blunt our concern until the problem stabs us in the face.
Experts in the field have warned for decades that we face a long term problem. Although you don’t need a doctorate in economics to work out that an increasingly elderly population, living longer, often with more complicated conditions being managed by ever more sophisticated treatments, is going to require an exponentially increasing provision of facilities and staff.
Lord Porter, chair of the Local Government Association, has warned that social care services are at “breaking point” and additional tax-raising powers and new money at the end of the decade would not alleviate immediate pressures. Caroline Abrahams, of Age UK, agreed government action was needed. “Few public services are as important as social care, and yet it is clearly in serious, progressive decline,” she added.
They say the only certainties in life are death and taxes, well a third outcome for all of us, assuming we managed to navigate the first two, is old age and probably increasing infirmity. Yet no government has really grasped this nettle, preferring to deal with what they see as more immediate problems in the hope that the elderly will just look after themselves or maybe conveniently drop off the twig before they become a burden on the state.
The idea that, as a modern society, we should commit central government resources to such things as helping people to the toilet or dressing seems never to have gripped politicians with the same zeal as the ability to wage thermonuclear war or get from Birmingham to London 15 minutes earlier. Testament to our societal priorities came earlier this month when Michael Fallon announced a £100m deal to improve RAF drones in the same week it was reported that seriously sick children were having to be transported long distances to receive intensive care because of a lack of beds in major cities.
There have been a few ill-conceived schemes brought in to try to paper over the cracks in social care. The most recent being the ‘Better Care Fund’ – an inbred chimera that tries to jam together the often competing priorities of the NHS and the DCLG. It’s been described by some as tinkering around the edges of the problem, whilst yet again bringing no new money to the table.
The idea that social care should be integrated into healthcare is actually not such a bad one. But of course if that were embraced fully, the government would have to commit proper funding to it, which it seems to want to avoid at all costs. As with many other issues, leaving the responsibility to councils under the guise of localism keeps the problem at arms length. It also heaps the blame on to them when provision becomes inadequate.
But with wild variations in income across the country, care budgets that rely on council tax take become a postcode lottery. In a particularly poignant paradox it means that poorer areas – where the problem may be most acute – will have the least money available. Health think tank The King’s Fund says the amount of extra money raised per head of the adult population varies from £5 in Newham and Manchester, to £15 in Richmond-on-Thames.
It’s pretty apparent why the Tories are keeping social care and the NHS apart. As an administration that’s already openly hostile to publicly funded healthcare, it doesn’t want to open up another channel by which it may become responsible for people who have had the temerity to reach advancing years without ensuring they have the benefit of an offshore account or a nice juicy private pension pot.
While we’re all enjoined to make sound financial arrangements for our later years, the government has done precious little to ensure the support mechanisms are there for those who have been unable to do so. A demographic that’s also going to get bigger as a result of many of their other policies..
To today’s emerging workforce, many of whom are struggling just to pay the rent and put food on the table, the idea of pension contributions or long term savings plans don’t feature too highly on the list of essentials. When you’re on a zero hours contract unable to see beyond next month’s pay cheque, your sunset years seem like a lifetime away, because I suppose they are.
The generation now being served by our creaking social care system were the first to benefit from the post-war prosperity that enabled ordinary working people to buy a house, bring up children and save for the future with relative ease. They also expected the retirement that they were promised and in the most part have since enjoyed and to be able to leave something to their children. But inheritances are a disappearing dream for most ordinary people as the value of the assets and savings of our forebears is swallowed up by costs for residential care or home help, assuming they don’t have the courtesy to die before any of this becomes an issue.
The reality is that care of the elderly is means tested and so increasingly self-funded. 1 in 10 people now spend £100,000 on care with 4 out of 10 having to pay for private care homes out of relatively modest means. Private care homes cost on average 50% more than council run facilities and council funding rules mean that most people will need to burn through their entire life savings until they are left with just over £14,000 to pass on to their children.
Many people may think that’s fair enough. If people have amassed wealth, why shouldn’t they be made to fund their own care in later life? But if these people have saved and paid taxes and national insurance all their lives, isn’t it fair that they should be able to rely on those contributions to look after them as well as being able to pass something on? Is that what community taxation was supposed to be about?
Moreover bequests are likely to be the only chance many of the next generation have of buying a home or saving for their own dotage. Theresa May has already acknowledged the ‘just about managing’ demographic and a recent survey revealed that millions of people now have less than £100 in the bank. People are struggling to save for the next electricity bill, let alone an old age they may not even see.
For now though the funding of care, such as it is, relies heavily on people having equity in property, some savings and perhaps a reasonable pension. But what awaits ‘generation rent’ living on zero hours contracts with virtually no savings when they reach retirement in 40 or so years time?
That’s of course if there are any residential care homes left for them to go into. Homes across the country are now closing at the rate of one per week and it’s a problem that’s set to get much worse. In 2016 Four Seasons Healthcare group closed 51 homes and announced plans to close a similar number in 2017 citing lack of money and inadequate funding for council referrals.
Care home closures leave many bewildered people in poor health, their life’s possessions thrown into bin bags with no idea or understanding of what awaits them in their final years. It’s the antithesis of the gold rush of private health companies eager to stake a claim on lucrative NHS services. There’s no easy money to be made from looking after the elderly, so investors just aren’t interested.
With dwindling council facilities, little funding and no appetite in the private sector to take on the mantle, what exactly are we going to do with the next generation of the elderly and infirm? People in the workforce now who probably won’t have savings or pensions to plunder for whatever private care there is left by the middle of the century. Social care is bad enough now, but if government funding continues to decline at its current rate, along with the deliberate destruction of the NHS, the chances are the generation after this one will witness an elderly population destined to become street dwellers begging for change from the worn-out seat of a broken down mobility scooter. Those that can’t manage that will presumably die alone to be quietly disposed of. Assuming councils have enough money to manage even that.
It may seem like a bleak prediction, but it’s not so far from the situation we were in a hundred or so years ago. It’s very easy for certain demographics to be forgotten about with no family or friends left to highlight their plight. Unless plans are made for all our futures now, there’s a real and very scary prospect that we’ll be heading back to those dark Dickensian days in less than a generation. That’s something we should all be fighting hard to prevent, while we’re still fit and able to do so.