This week signalled an historic moment for the future of care in England. For the first time ever, anywhere, the UK government has placed a cap on the amount disabled and older people will have to pay for their care.
This was welcome news in principle for older and disabled people who worry about their future and whether their savings will last long enough to pay for the care that they need. And to that extent is uncontroversial, although debate will continue over the level of the cap that taxpayers can afford and other fine details.
But this is only the first and least important step of reforming a pattern of public expenditure in England, where it has historically been better in financial terms to be ill than disabled.
The shocking truth is that at this moment, nearly 70,000 disabled people in this country do not receive care that meets their basic needs, such as washing or dressing, or eating a hot meal every day.
Unlike the NHS, non-medical care for disabled people is not free. This means that local authorities set tight criteria about who can receive support - only people with the most urgent needs are found eligible for care, and thousands of people get no support at all. This will not change under the new system.
Someone who regularly struggles to perform basic tasks like getting dressed, washing or preparing a meal, in the vast majority of local authorities receives no support. Too often this means life savings spent on support, family members giving up work to become carers or, most worryingly, simply going without any support at all.
The government is tackling the anxiety of people having to face unlimited care costs in the future; now they must take the second step of their historic reform programme and tackle the disgrace of people in need today.
There is so much extraordinary care being delivered every day, but the third and important step is to make sure that all care is good care - care that we can be proud of.
As highlighted by the Care Quality Commission this week, short visits and a lack of staff continuity make for poor care. This is not what we would want for our own family members. Most care workers are wonderfully dedicated people but they are asked to accomplish the impossible. In a 15 minute visit, where a carer barely has the chance to take off their coat, it is rarely possible to provide care with empathy and respect. It feels more often to the care worker and to the recipient like box ticking. This is not ok and every compassionate tax payer who saw it would say 'not in my name'. When money is tight - and we all know public money is tight - it is vital for us all to have confidence that it goes to those who have the greatest need.
The government has taken an important first step with the care cap. Now we must come together and take the next steps towards care which we really can all be proud of.
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