Social care is in crisis
Frail older people in hospital beds is the image which stays with me more than any other from my first four months as Labour’s shadow secretary of state for health.
I have visited numerous hospitals up and down the country, and I have lost count of the number of times I have turned a corner to see a frail elderly person, often alone, sitting or lying in a bed. It is an uncomfortable image and one that always leaves me asking, ‘Is this the best place for them and is this the best our health system can do for them?’
The image is uncomfortable, but the numbers are shocking. One in four hospital beds are occupied by someone with dementia. Half of people admitted to hospital are over the age of 65. And over 300,000 people over the age of 90 arrive at A&E every year.
When we get older – and it will come to all of us – hospital will sometimes be necessary but it should not become the norm. We need to grow old with the comfort and security to know we will be cared for in a setting that is right for us and is right for a modern health system.
When Aneurin Bevan founded the NHS in 1948 he said: ‘Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised.’ That principle was right for the NHS then and it is right for how we care for our elderly today. Growing old is not a misfortune, it is a privilege and we should not punish people because of it.
The crisis in social care is going to cast a dark shadow over this parliament. A toxic combination of a chronic lack of funding over the past five years, plus rising demand and increased costs, have left the care sector in a perilous state.
At various points experts have put forward solutions. Politicians have then tinkered around the edges. But time and time again we have failed to grasp the nettle. We have allowed social care to be pushed into the ‘too difficult’ box. The consequence? Poorer, older people left suffering in silent misery, without the care and support they need to live their lives with dignity.
Ministers are in denial about the state of social care in England. However, the experts are telling a disturbing story. The King’s Fund is warning that ‘the social care system in its current form will not survive’ and the care home sector is ‘at risk of collapse’. This will have tragic consequences for older people in our communities and cause further damage to our NHS.
You cannot dismantle social care and not expect the NHS to feel the pain. Increasing numbers of frail, elderly people are reaching crisis point, ending up in A&E and then getting stuck in hospital. This could be avoided if they had the right care and support at home. Instead, the NHS is spending millions of pounds paying for the costs of this government’s misguided policies.
With the government seemingly more interested in picking fights with junior doctors and trainee nurses, it falls to us, the Labour party – the party which founded the NHS – to fight for a properly funded care system.
In this parliament we must be bold in our policies and honest in our politics to find a long-term, sustainable solution. We cannot let this opportunity slip by us once again. It is make or break for social care. If we fail today we will be letting down families for generations to come. Neither I, nor the Labour party, will let that happen.
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Heidi Alexander MP is shadow secretary of state for health
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It’s difficult to disagree with anything in this article, but the key phrase is surely “a properly funded care system”, and there’s really only three ways to achieve that – all of which are problematic: higher taxes, borrowing more, or putting the onus on individuals to fund their own care.
Given the public’s clearly expressed desire to bring the deficit down and the complete lack of trust that they have in Labour on this subject, borrowing more doesn’t seem to be viable – besides this isn’t a problem that’s going to go away, we would have to keep borrowing more forever.
Higher taxes – if we could manage to persuade the public that there is simply no other way to have the health and social care system that we need other than to put x pence on income tax, and that this money would ONLY go towards these departments, then this might be an option. But again, it risks confirming Labour as the “tax and spend” party.
As for asking individuals to pay (as effectively happens now), this goes against all the founding principles of the NHS (as Heidi Alexander points out). But perhaps there is some middle way in terms of setting up a government-backed insurance scheme into which individuals can pay an additional amount of tax which then entitles them to a guaranteed level of social care should they need it (thereby avoiding the need to sell your home, for example). The progressive element of this would be that someone on a low income who paid in would be entitled to exactly the same level of care as someone on a high income even though they would have contributed more in cash terms. Of course this solution is not ideal because it still leaves a lot of people who will not have paid into the scheme.
However, we need to come up with something – otherwise attacking the Tories for under-funding social care is just so much whining.
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Is this called National Insurance contributions?
Governments have avoided dealing with this for decades – the financially weakest will live out the lives in bleak situations whilst the rest of us scramble to acquire or hold on to wealth in fear of needing to rely on the state.
We need honest politicians and media to tell us bluntly how it is.
I do mean decades – I remember when the Thatcher Governement decided that people over 18 but under 26 did not need as much financial support as over 25 year olds. I think that was in 1988, 7 years after the Community Care Act which began the problems with Social care and since which time some have made a profit from it whilst others work for minimum wages and others live in misery.
Labour talked a great game but then did not deal with the basic problems and also faille to return rights to Trade Unionists.
the crisis was predicted – it is happening, meanwhile prison numbers stay high and probation is nullified as even some of that spending is given to privateers to cream off.
the issues are simple – they are explained in simple fashion here
https://jeffgoulding.com/2016/01/31/monopoly-and-the-ideologies-of-division/