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I have a detailed plan to address social care said Johnson one year ago

July 28, 2020 2:00 PM

One year ago Boris Johnson pledged to fix the social care crisis

A year later and with over 22,000 Covid-19 deaths* in the community and care homes we still await his 'oven ready' detailed plan

Including social care among a string of domestic pledges, Johnson said at the time "My job is to protect you or your parents or grandparents from the fear of having to sell your home to pay for the cost of care. And so I am announcing on the steps of Downing Street that we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve."

This week, The Guardian revealed that the government's Health and Social Care Task-force and the Department of Health and Social Care were considering plans for people over 40 to pay more tax or national insurance in order to meet their later life care costs which is similar to schemes already in place in Germany and Japan.

Johnson pledged to fix social care when assuming office a year ago but has since dampened down expectations by revealing it could take five years to implement reforms. According to a recent poll less than one in five people said they believed the PM would implement social care reforms in the current Parliament

Steven Cameron, Pensions Director at financial services provider, Aegon, said: "The COVID-19 pandemic has made it even more imperative that we solve the social care funding crisis. Finding a fair and sustainable solution will inevitably involve a sharing of costs between the state and individuals, based on their wealth or income. Introducing an additional band of income tax or National Insurance ring-fenced to go towards social care costs is worth exploring and would mean those on higher earnings pay more into the fund.

"Applying the new tax to those above say age 40 may raise questions over inter-generational fairness and the government needs to look at the wider support it is offering for each age group. While paying more tax is not going to appeal to everyone, homeowners might see it as a price well worth paying if it came with a cross-party lifelong guarantee that in return they will not have to sell their home to pay for future social care."

Jon James, reports that at the recent Lib Dem Eastern Region Leadership hustings he asked candidates Ed Davey MP and Layla Moran MP, what plans they had for the adult social care sector and how it could be funded? They both said it was a priority and referred to the Sir Andrew Dilnot, cross party Commission on Funding for Care and Support in 2010 set up by the Coalition Government. A subsequent Bill was actually approved and signed by the Queen in 2015 and almost passed but was then delayed by the 2015 general election and a lack of political support from returning Tory Prime Minister David Cameron and George Osborne Chancellor of the Exchequer who postponed it until 2020.

Speaking to the King's Fund in a podcast on finding a solution for social care funding, Sir Andrew Dilnot said: "Legislation went through, the Queen signed the Bill, and in politics 101 you learn that once the Queen has signed the Bill, you're over the line. "There was an agreement at that point to implement recommendations, and then after the 2015 general election the then Chancellor of the Exchequer postponed it until 2020."

The Dilnot Commission recommended a partnership model with a much more generous means test and a lifetime 'cap' of between £25,000 and £50,000 on social care costs to ensure the state steps in where people face catastrophic costs that cannot be planned for.

Its recommendations included the need for a public information campaign, but this never emerged.

"It was a recommendation for social insurance, collective provision, with a relatively large excess," said Sir Andrew.

The Commission came about after a long history of delays to social care reform. "Part of the 2010 Coalition Government Agreement was a text that made it very clear that the partners felt very strongly that social care urgently needed to be addressed, so they set up a Commission."

In the first 18 months after the Dilnot Commission was formed, its recommendations were met with warm words from all parties, who thought a cap on care costs was a good idea, but nothing came of it, and Sir Andrew almost gave up on getting social care reform over the line when he was thrown a lifeline.

"I did what must have been the 100th or 150th talk about it at the House of Lords and three or four peers - all of them Lib Dems - came and said to me 'why hasn't this happened?' and I said, 'well, because there hasn't been enough political leadership'."

"They went off and spoke to Nick Clegg and said 'come on, this really is something that needs to happen'. Nick Clegg was persuaded, which led to David Cameron being persuaded."

'This was in 2013. Legislation then went through and the Queen signed the Bill just before the 2015 general election, after which it was put on hold by George Osborne'.

There was a Royal commission on long-term care as early as 1998, but the government didn't accept its recommendations. Then, in the run up to the 2010 election, politics intruded once again.

"The Labour Government, had some plans in place for what they wanted to call a National Care Service, and that seemed to be making some progress. Then when the election campaign got going, politics intruded and the Conservative party made a decision to be critical of the Labour Party proposals, labelling them as something that would lead to a death tax," explained Sir Andrew.

Reflecting on what went wrong, Sir Andrew said: "The major obstacle is almost always the money, and honestly a lack of strong support from the Treasury and strong support from the Prime Minister.

"In the aftermath of the 2015 general election there was anxiety about the public finances. But honestly, these amounts of money are not very large and I think it was much more about expanding the envelope of government activity than a concern about precise amounts of money that were involved.

"Then we had the complete debacle of the 2017 conservative manifesto when it seemed like a good idea to some people at the time to invent a new policy almost on the back of a cigarette packet, and that ended in terrible disruption."

Sir Andrew is referring to Theresa May's proposal to raise the threshold of personal assets at which people are eligible for state help with care costs from £23,250 to £100,000. She argued that a cap on care costs was no longer needed.

"Since then there has been promise of a Green Paper but I think it had become a politically toxic thing for the PM and so we weren't able to get it over the line," he said.

Asked by the King's Fund what critical ingredient was needed to get social care reform over the line, Sir Andrew said: "I think it's the Prime Minister and the Chancellor of the Exchequer both believing that they've got to do it."



Office for National Statistics *

  • Since the beginning of the coronavirus pandemic (between 2 March to 12 June 2020, registered up to 20 June 2020), there were 66,112 deaths of care home residents; of these, 19,394 involved COVID-19, which is 29.3% of all deaths of care home residents.
  • The Care Quality Commission (CQC) in England reported that between 10 April and 19 June 2020, there were 6,523 deaths of recipients of domiciliary care; this was 3,628 deaths higher than the three-year average (2,895 deaths).

Sir Andrew Dilnot: Sir Andrew Dilnot, CBE is a British economist and broadcaster. He was formerly the Director of the Institute for Fiscal Studies from 1991 to 2002, and was Principal of St Hugh's College, Oxford between 2002 and 2012. As of September 2012 he is Warden of Nuffield College, Oxford.



Over 40s would pay social care tax under reform proposals

Sir Andrew Dilnot on social care reform: Where did it all go wrong? ( incl extracts from the Kings Fund Podcast interview with Sir Andrew Dilnot) LEADERSPEOPLE by SARAH CLARKE on AUGUST 8, 2019

A Bill to reform the social care system was almost passed four years ago, but political intrusion led to its derailment at the 11th hour, a former government advisor has said.