Social Care Disunity – The Key Issue For The General Election
At a high-tech launch event in London today, Health Secretary Andy Burnham published the eagerly anticipated Social Care White Paper, Building a National Care Service. Following months of high profile disputes and bickering between the top three parties, the publication of the White Paper is unlikely to keep the issue of social care reform out of the media or away from the campaign trail as we approach the General Election.
As an indication of the political muscle to be used in the debate going forward, Gordon Brown endorsed Burnham’s reforms this morning. It surely will not take long for David Cameron and Nick Clegg to rally behind their teams. At the very least, they will be expected to provide answers when they go to the country after Easter.
Social care has for a long time been an embarrassment to the New Labour project and the Party has been all too aware that it has taken 13 years for the Government to address the issue. Over the last two years it has been clear that there has been a consensus on the need for reform – the current system is perceived to be unfair, underfunded and in the words of the Health Select Committee, politicians’ failure to achieve reform “would betray future generations”.
Where a consensus could not be reached, however, was how the system should be reformed and who should foot the bill for care. As the considerable media coverage highlighted, for a short while a consensus amongst the three parties did exist, with Burnham, Andrew Lansley and Norman Lamb all meeting privately to agree a way forward. This was not to last long and the public collapse of the talks – most neatly summed up by the raucous appearance of all three spokesmen on the Daily Politics in February – ensured that the issue would become the key health issue in the run up to the 6 May. The Conservatives appeared to have spotted a political opportunity and cringe-worthy exchange of accusations and criticisms continued to fly back and forth, demonstrating the adversarial and emotive nature of the debate.
For the Conservatives, Labour’s favoured funding option – where everyone would make a contribution to fund their future care – was no more than a “death tax”, and the publication of the their controversial billboard, said to have divided Conservative Central Office, continued the negative tone of the debate on this issue. Today’s White Paper has very much been framed to nullify this assessment, with issues relating to funding social care to be deferred to a new commission to be established after the election. This move will only achieve so much and the Conservatives will be quick to portray the Government as dithering on this issue.
The Conservatives alternative – the £8k insurance option – will do much to appeal to middle England and their core vote, setting out the perceived evil that is the need for the elderly to sell their homes and give up their savings to pay for care. On Sky News this morning, Lansley repeatedly emphasised the importance of choice and the need for individuals to choose what option was right for them, rather than face a compulsory tax in their lifetime. Whilst they are supportive of the principle of a National Care Service, for them the issue boils down to choice. This said, the popularity of Lansley’s favoured funding option is not clear – with only 22% of those consulted as part of the Government’s “Big Care Debate” endorsing the insurance option. In this respect, he would be wise to focus his comments on the concerns relating to the Government’s proposals rather than the specifics of the Tories own plans.
The reaction from stakeholders is mixed. Counsel and Care’s Stephen Burke has argued that the White Paper provides “a road map and a clearer direction towards better care”, whilst Anna Dixon of the King’s Fund states that the “White Paper still leaves many questions unanswered.” Yet, they will be united in the view that the momentum for reform was lost some months ago, and the reality is that the White Paper is intended for political audiences. With an election in our midst, reform of the social care system is up in the air and will remain the key dividing line between the three parties on health. In the meantime, Burnham will be worried that the proposals will fall at the first hurdle – as the Personal Care at Home Bill risks being scuppered in the Lords this evening, despite commitments today that the Government will “give what they can” to get it through before Parliament rises for the election.