First the good news. We’re having a vibrant debate about social care funding slap bang in the middle of an election campaign. Now the bad news: the policy that has prompted the debate is a stinker. Theresa May and her advisers deserve credit for instigating the former and derision for the proposing the latter.
How May now responds to the furore will likely determine whether we take some serious steps towards solving the social care crisis or continue for many more years with a crumbling system held together by the sticky tape of short-term Budget announcements.
It’s important to acknowledge how bold the Conservative manifesto is and how, despite its evident failings on social care, it does represent a breakthrough.
It was heartening, for example, to see an ageing society being listed right up front of the manifesto as one of the ‘five giant challenges’ confronting the country alongside Brexit and the need for a strong economy. This is a potentially significant turn in political discourse on the issue of ageing.
The manifesto broke new ground in other important ways. It implicitly admitted that the fundamental problem of social care is not the variable nature of council provision, bed-blocking or some other red herring regularly thrown out by the previous Government: it is money. It also risked touching a political third rail by proposing means-testing for winter fuel payments to help with social care funding starkly acknowledging the unsustainability and injustice of the largesse shown to the wealthy old at a time of rising demand for care.
Maybe most surprisingly, though, the manifesto made a direct link between social care and inheritance wealth. This is a very profound step when for years the trajectory in politics has been towards protecting and extending the right of elderly people to pass their wealth onto their middle-aged offspring. A trajectory that has continued no matter what the pressure on the public finances to care for the elderly nor the absurdity of defending the right of people to receive assets for doing nothing more productive or enterprising than being born to their parents.
Sadly, the political courage that led to these bold steps seems to have deserted the Conservative leader when it came to the detail. Instead of developing a plan to share the rising cost of social care across the population – the approach anyone who has looked at the issue in detail has ended up proposing – the manifesto opts to load potentially unlimited cost onto the individuals in receipt of care. Given this choice was probably made to allow the Tories to continue describing themselves as a low tax party during the campaign, it is ironic that the proposal has immediately been dubbed the ‘dementia tax’.
It would be tempting for May now to simply back away from the proposals and mutter something vague about it all being open to consultation hoping the press rapidly moves onto another issue. That, however, would miss a golden opportunity to both grab the social care issue with both hands while taking the sting out of her opponents’ attacks.
Theresa May needs to make it clear in person to the public, as her manifesto does, that there is no easy or cheap solution to our ageing population and the rising demand for social care. The real question is how we pay and in what proportion that payment is shared between state and individual. She could admit that her proposed policy might not have got the balance right and will need to be revisited rapidly in the planned green paper. That consultation though will include policies proposed by Labour and the Liberal Democrat manifestos of higher taxes which might fall across the whole population, on the better-off or maybe even on the holy sacrament of inheritance.
That way May will keep open the vital debate on social care while making it very clear that nobody in this over-heated slanging match is offering a cost-free solution and that accusing only one party of proposing a ‘dementia tax’ only serves to distract us from the hard truths and tough choices posed by an ageing population.