The residents of Surrey are being asked by their county council whether they support a 15% increase in council tax to pay for local care services.
The Surrey referendum raises several big questions. Will council tax payers be prepared to accept a large increase in their bills to serve some of the most vulnerable local residents? Do they recognise that care services are at breaking point after years of central government budget cuts?
It also raises a much more fundamental question: is a 15% hike in council tax the best way to deal with the care crisis?
While councils around the country are setting their 2017-18 budgets, all eyes are on Surrey. Other councils have chosen to go for a 5% increase in council tax - the maximum they can increase bills without having to call a referendum. Some are freezing bills or going for a smaller increase.
The reality in Surrey is that a 15% increase will still not avoid the need for further budget cuts. And it's unlikely to improve care or access to care. It is simply a move to stop care getting worse and protecting the most vulnerable.
What the Surrey proposal highlights is the growing postcode lottery in care. Where you live and your council's financial position will increasingly determine what help you can get with care, if indeed you are able to access any help.
It's a double whammy for families on low to mid incomes. Not only will they find it harder to get help with care, they will also be asked to pay more council tax. Because council tax is an unfair regressive tax, it is these families who will bear the brunt of the council tax increases. At the same time the government clearly expects families to pick up more and more of the costs of care.
By focusing on the problems of funding care, Surrey County Council deserves credit for shining a light on this issue. But council tax increases are not the answer to creating a fair, simple and sustainable care system. What will Surrey do in 2018 and beyond - more 15% increases?
The debate around Surrey's proposed council tax increase must now become a debate about how care should be funded properly by central government through taxation. A key principle is that funding should be based on sharing the risks and the costs of care.
Here are five elements of what I believe would be a fair and sustainable care system:
- A clear vision of the care system in 21st century Britain, ambitious for our ageing population and their families and providing independence, control and early intervention
- An integrated system which brings together care, health and housing as inseparably entwined parts of the solution to helping older and disabled people live well, safe and warm at home
- A single body locally would be responsible for commissioning and funding joined up health and care within a strong national framework to end the postcode lottery
- More support for family carers so that better care becomes a key part of the economic and social infrastructure that makes the country and family life work for all
- The funding of care must be similar to health ie free at the point of need and funded by taxation, with government ensuring sufficient revenue to meet growing demands
A new vision has to win popular support. Universality is key to ensuring buy-in from the whole population and to tackling the unpopular and fragmented local variations that currently exist. Universality is also critical to raising the status of care and caring, and the value placed on care.
The question now is whether Surrey's referendum has provided the tipping point for such fundamental change.
Stephen Burke is director of Good Care Guide and United for All Ages