More delays on health and social care proposals!

July 19, 2011   Carers, health

Health and social care need equality

Dilnot proposals for social care divide the government, causing more delay to necessary reform, argues Peter Beresford

 

The proposals by Andrew Dilnot’s commission were described as ‘clever’, but now the coalition partners cannot agree on them. One of the words most often used about the proposals of the Dilnot commission was “clever”. As ever, social care, denuded of finance and political priority, was in search of some smart solution that would gloss over the essential reality of political life – that you get what you pay for.

This is now brought into sharp relief by the apparent inability of the coalition partners to agree on Dilnot’s proposals. After the report launch, we heard very positive and supportive responses from both Norman Lamb MP, the deputy prime minister’s political adviser, and the care minister, Lib Dem Paul Burstow. But this was not echoed by either the chancellor of the exchequer or the prime minister.

The reality is that social care highlights the very substantial ideological differences within the coalition, just as health reform does. This takes us back to the run-up to the last general election when, while Lib Dems and Labour could engage in constructive discussion about social care, Conservative spokespeople such as Andrew Lansley made it clear that they were in a very different place, and invented the killer label “death tax” to bury Labour proposals.

So for all the recent talk of the need to build consensus and go forward with potentially sustainable proposals, the social care situation yet again looks like one of delay and dither. The minister has said that disagreement will now hold up intended legislation.

All this is being played out while the Southern Cross crisis remains unresolved, perverse incentives that encourage the institutionalisation of older people remain and ever-narrowing eligibility criteria and reduced budgets are making a mockery of policy aspirations for prevention and equity.

A fundamental difficulty with social care is said to be that the public don’t really understand it, so don’t exert the same pressure on politicians as they do over the NHS. But is it really that they don’t understand it, or could it be that they actually understand it a lot better than many politicians and policymakers? Have they intuitively realised that it isn’t and shouldn’t be treated separately from health, because there is so much overlap?

If they are right, then what makes most sense and offers most hope for health and social care integration is at last accepting the need to put health and social care funding on the same footing. Recent governments have not wanted to face up to this, but their inability to come to agreement on anything less may well highlight the crucial need to reopen discussion on the subject.

http://www.guardian.co.uk/society/joepublic/2011/jul/19/social-care-reforms-delay

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