Solving the crisis in social care requires the Government to make tough choices - Andy Brown
People have been warning for well over a decade that we were going to have a lot more elderly people in the population and that it would become increasingly expensive to look after them. Well respected politicians from virtually every political party have warned about the size and the cost of the problem.
Serious action has been in short supply.
Governments have preferred to dither than to implement policies they find politically unpalatable. Almost everyone agrees that there are too many people in hospital beds and that they could be looked after better and more affordably if we created more care home facilities and staffed them with specialist teams.
Unfortunately, that requires providing local government with significant amounts of investment funding to build or commission more and better care homes and it involves properly funding the payment and the training of care staff. So far, no government has proved willing to put up taxes for working age people to pay for that.
Theresa May tried to grapple with this problem. The opposition she faced from within her own party resulted in her having to announce three separate care policies in one brief election campaign. None of them got properly adopted.
A more recent version of the current government announced, with great fanfare, that it was going to cap care costs at £100,000 of lifetime contributions. North Yorkshire was chosen as a pilot area to put the scheme into practice to ensure the national roll out went smoothly. Then the entire project was dropped. Quietly and without fanfare.
It is worth pausing a second to consider why that matters. As things stand, if your relative develops dementia, and the care they need goes way beyond what anyone in the family is capable of providing, then their assets are assessed. If they have more than a low threshold then they pay the full cost of the care.
Relatively straightforward live-in care typically costs £1,500 a week. Complex dementia care a lot more. So, week after week, month after month, year after year large amounts of cash will go out as your family member uses up their lifetime savings to pay for help.
If by contrast your relative remains relatively healthy in old age and dies relatively quickly and painlessly then you are allowed to inherit one million pounds completely free of any tax.
The political choice to provide such generous policies on inheritance may be popular but it isn’t wise. It makes inheritance a lottery. Some pay a fortune on care whilst others are fortunate enough to be able to pass on all their wealth without needing to make any contribution in their old age to the cost of providing health and care.
Looked at dispassionately, inheritance tax is the single easiest and least painful way of paying for the cost of care in an ageing society. Any political party that chooses to take the soft option of lowering inheritance tax will end up cutting services or making someone else pay. What is better, to pay hefty income tax on your own earnings in mid-career or to get a lower inheritance passed down to you from a relative?
Anyone who thinks both income tax and inheritance tax can be lower without consequences might be wise to spend some time with an elderly person after their social worker has rushed out of the door because their 30 minute daily time allowance with them has expired. Or take a close look at the standard of some of the facilities in which some of the elderly people who depend on local authority support have to live. Or to listen to the reaction of families when they first realise the phenomenal cost of providing their parents with the standard of care that they want them to have. The unpopular hard reality is that if we want services to work they have to be paid for. Or rather one of the unpopular realities. The other is that services have to be staffed.
It isn’t easy to find people with expertise who are willing to work on the complex and challenging but rewarding work of looking after the elderly when there are better wages available and a lot less stress working the tills at the local supermarket.
It becomes even harder to attract and retain good staff when real wages get reduced every year and the reward for risking their own lives during Covid is applause on the doorstep followed by a decline in their standard of living. Genuinely raising wages for social workers is expensive and rarely the first choice in the government’s budget. Whilst I’m on unpopular but unavoidable choices. One final one. There is a very easy way of increasing the workforce in care and a ready source of young fit workers wanting a chance to take up jobs.
All we have to do is to allow asylum seekers to work whilst they are waiting for their applications to be processed.
Andy Brown is the Green Party councillor for Aire Valley in North Yorkshire.