Government must take up Dilnot proposals
26 July 2012
Could Andrew Dilnot and his colleagues have completed mission
impossible and found the key to making sustainable reforms to the
adult social care system? On an initial look, the answer may well
be "yes." The recommendations from the Commission on Funding Care
and Support seem fair, sustainable and could solve a lot of the
social care problems that currently exist. But there is a caveat:
it's going to cost. How to reform the funding of social care has
been a question that has vexed successive governments, with none
seemingly able - or willing - to come up with a sustainable
solution. Royal Commissions and white papers have come - and gone
again - with little change to the current system, acknowledged by
many for years as not being fit for purpose. But the Commission for
Funding Care and Support - aka the Dilnot Commission - has come up
with a report, Fairer Care Funding, that might have just
cracked this trickiest of political problems. Some of the headline
recommendations include limits to the amounts people will pay
towards residential care, retaining universal benefits and
introducing standardised eligibility criteria for services. For a
fuller list of recommendations, click here. Looking through it, it is hard to
argue against the recommendations. Social care was never going to
be made free - in an ideal world it would be, but this isn't an
ideal world - and this is a viable way forward for paying for it.
Other measures echo what people with disabilities and their carers
have wanted for years - such as standardised eligibility criteria
for services, portable assessments and more information and advice
made readily available. It's nice that someone has finally
listened. The response to the Dilnot Commission from the social
care sector has been, in the vast majority, supportive and
welcoming. Most of the comments I saw on Twitter were similarly
positive. However, and more worryingly, the response from the
government has been muted. Health secretary Andrew Lansley said
finding the money would be a significant challenge - and would have
to be weighed up against other spending priorities - but added that
social care reform was a priority. Hardly a glowing welcome.
Meanwhile, Labour leader Ed Miliband said he was willing to engage
in cross-party talks, but little else. That is something, however.
This issue is not a matter for party politics. There should be
cross-party consensus on the future of adult social care funding to
ensure that the system that is finally settled upon is in place for
decades and not torn up as soon as another administration takes
over. For once, the tribalism of Westminster must be shelved for
the good of the country. While the last time MPs tried to do this -
when Labour produced its 'National Care Service' proposals last
year - the talks foundered, but this time there isn't an impending
election to cloud thinking so talks may be more fruitful. But
Lansley touched on the major stumbling block as to whether Dilnot's
recommendations make it off the ground or not. Dilnot reckons his
recommendations will cost the government £1.3-£2.2 billion to
implement. With Chancellor George Osborne looking to cut costs at
every opportunity - which is already impacting on social care
budgets through cuts to local authority money - will he baulk at
this extra cost? From the government response so far, my gut
feeling is "yes". Indeed, where would Osborne get the money from?
Increased taxes (never a vote-winner)? Moving spending from other
sectors - and therefore cutting other services? It's a thorny
problem. But on the other hand, as think-tank Demos pointed out on
Twitter, the proposals will cost 1/400th of public
spending and fix a lot of social care problems. Can the government
afford not to implement? Would the costs of not implementing
Dilnot's recommendations exceed those of implementing? These issues
need to be addressed; kicking social care into the long grass again
is not an option. Dilnot's proposals are the best that anyone has
come up with so far and have widespread support from the sector.
Despite the cost, reform needs to be implemented, and this should
form at least the basis - if not the majority - of it. But we shall
not know the government's plans for some time, unfortunately.
Dilnot's report will be added to the Law Commission's recent
recommendations on social care law, and will go into a social care
white paper, which is expected in Spring 2012. Only then will we
find out if Dilnot's mission impossible was a fruitful one…
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