Could Andrew Dilnot and his colleagues have completed missionimpossible and found the key to making sustainable reforms to theadult social care system? On an initial look, the answer may wellbe “yes.” The recommendations from the Commission on Funding Careand Support seem fair, sustainable and could solve a lot of thesocial care problems that currently exist. But there is a caveat:it’s going to cost. How to reform the funding of social care hasbeen a question that has vexed successive governments, with noneseemingly able – or willing – to come up with a sustainablesolution. Royal Commissions and white papers have come – and goneagain – with little change to the current system, acknowledged bymany for years as not being fit for purpose. But the Commission forFunding Care and Support – aka the Dilnot Commission – has come upwith a report, Fairer Care Funding, that might have justcracked this trickiest of political problems. Some of the headlinerecommendations include limits to the amounts people will paytowards residential care, retaining universal benefits andintroducing standardised eligibility criteria for services. For afuller list of recommendations, click here. Looking through it, it is hard toargue against the recommendations. Social care was never going tobe made free – in an ideal world it would be, but this isn’t anideal world – and this is a viable way forward for paying for it.Other measures echo what people with disabilities and their carershave wanted for years – such as standardised eligibility criteriafor services, portable assessments and more information and advicemade readily available. It’s nice that someone has finallylistened. The response to the Dilnot Commission from the socialcare sector has been, in the vast majority, supportive andwelcoming. Most of the comments I saw on Twitter were similarlypositive. However, and more worryingly, the response from thegovernment has been muted. Health secretary Andrew Lansley saidfinding the money would be a significant challenge – and would haveto be weighed up against other spending priorities – but added thatsocial care reform was a priority. Hardly a glowing welcome.Meanwhile, Labour leader Ed Miliband said he was willing to engagein cross-party talks, but little else. That is something, however.This issue is not a matter for party politics. There should becross-party consensus on the future of adult social care funding toensure that the system that is finally settled upon is in place fordecades and not torn up as soon as another administration takesover. For once, the tribalism of Westminster must be shelved forthe good of the country. While the last time MPs tried to do this -when Labour produced its ‘National Care Service’ proposals lastyear – the talks foundered, but this time there isn’t an impendingelection to cloud thinking so talks may be more fruitful. ButLansley touched on the major stumbling block as to whether Dilnot’srecommendations make it off the ground or not. Dilnot reckons hisrecommendations will cost the government £1.3-£2.2 billion toimplement. With Chancellor George Osborne looking to cut costs atevery opportunity – which is already impacting on social carebudgets through cuts to local authority money – will he baulk atthis extra cost? From the government response so far, my gutfeeling is “yes”. Indeed, where would Osborne get the money from?Increased taxes (never a vote-winner)? Moving spending from othersectors – and therefore cutting other services? It’s a thornyproblem. But on the other hand, as think-tank Demos pointed out onTwitter, the proposals will cost 1/400th of publicspending and fix a lot of social care problems. Can the governmentafford not to implement? Would the costs of not implementingDilnot’s recommendations exceed those of implementing? These issuesneed to be addressed; kicking social care into the long grass againis not an option. Dilnot’s proposals are the best that anyone hascome up with so far and have widespread support from the sector.Despite the cost, reform needs to be implemented, and this shouldform at least the basis – if not the majority – of it. But we shallnot know the government’s plans for some time, unfortunately.Dilnot’s report will be added to the Law Commission’s recentrecommendations on social care law, and will go into a social carewhite paper, which is expected in Spring 2012. Only then will wefind out if Dilnot’s mission impossible was a fruitful one…
