So, what's the 'Dilnot-o-meter' about?
We have launched a new
measurement tool that is set to transform our views on social care.
Well, not really. Basically we're setting up a gauge that we will
update with our judgement on whether the government is going to act
to resolve the enormous problems we face in funding social care
(i.e. support, for example, to help people dress and eat if they
cannot do it themselves). The government has in front of it a clear
solution, proposed by Andrew Dilnot and his team on the Commission
for Funding Care and Support. They have promised a response soon,
and the clock is ticking... Which way will they swing?
If you didn't realise there were problems in funding social
care, then read on.
Richard Humphreys, the social care expert at the King's Fund,
tells a joke about the end of the world. Essentially it is that
when virtually everything has been destroyed and there are just a
couple of cockroaches left, they will still be arguing over how to
fund social care.
That black humour comes from years of wrangling over an issue
that politicians of all sides have chosen to ignore. It stems from
our rising life expectancy, an overwhelmingly positive trend that
also brings with it some problems. One of these is the increasing
need for care that many people have in the latter years of their
lives. Already this increasing need has brought our current social
care system to crisis point. There is not enough money going into
the system and the way it is used is unclear and unfair. The most
obvious unfairness is people of modest means having to sell their
homes to pay for their care. it is compounded because most people
simply don't understand why NHS care - GPs, hospitals etc - is
largely free but social care is not.
The most recent attempt to decide how to pay for that care is
the Commission on Funding Care and Support, chaired by Andrew
Dilnot, which reported earlier this year. His solution builds on a
consensus that has emerged in recent years that the cost should be
met in part by the government and in part by the individual.
Dilnot's big idea is to set a clear 'cap' on the amount that the
individual will pay so that he or she can plan and insure for it.
Care costs, argues Dilnot persuasively, are the only potentially
devastating costs that we cannot insure against and this is because
insurers have no way of knowing the maximum they will have to pay
out. A 'cap' solves this problem.
Despite the simplicity of this idea, and the overwhelming
support it has received from all sides in the argument, the
government has still not committed to it. What holds them back is
fear of the cost: not so much the extra £1.9bn that is needed to
implement it now (just 1/400th of all government spending, as
Dilnot keeps on reminding them) but the fear of what the cost might
be in a few years time.
Yet there really is no other solution available. The money has
to be found. Many people argue that it may not mean extra spending
but rather better use of the current spending, particularly the NHS
budget, which currently runs to well over £100bn. Spending money on
basic care and support for people often means that they don't
become ill or depressed or have accidents and need urgent,
expensive treatment in hospitals. Yet despite a great deal of
evidence on this, little of the health budget is in fact spent on
prevention and lower-level care. That needs to change and, if it
did, we might find that our fears about funding social care were
unfounded.
Read our latest Dilnot-o-meter blog and add your
comments to join the conversation.
