There is a common refrain in the care sector: we need a cross-party commission/agreement to tackle the care crisis.
There is (almost) consensus on the problems facing the sector, starting with underfunding and market failures. But still there is little agreement on how to tackle these fundamental problems beyond an immediate cash injection in the autumn statement on 23 November - even though many think pouring money into an unreformed system is no more than a sticking plaster at best.
So 17 months into the current government, what are the chances of a cross-party commission? And is it the right way forward?
We have a government that doesn't seem to have care high up its agenda. In July the Prime Minister appointed David Mowat as Parliamentary under-secretary of state for community health and care. His predecessor had been a minister of state, so the care minister has been demoted.
This is despite increasing recognition within government about the knock-on effects of inadequate social care provision on the NHS. There is growing pressure to put any extra money for health directly into care to support older people in particular at home and in their local communities and keep them out of expensive hospital or residential care.
So what will make the government sit up and take the urgent action needed on the care crisis?
Well, a cross-party commission is hardly a recipe for urgent action.
We had the Dilnot commission, set up in 2010 by the coalition. It reported in 2011. The government responded in 2012. Some of the Dilnot recommendations were incorporated in the 2014 Care Act to be implemented the following year. After the 2015 election the new government put the Dilnot cap on care costs (hardly the most radical of proposals) on hold until at least 2020. In all, some ten wasted years.
Previous efforts at cross-party consensus have not fared better. The Labour government in 2009-10 held cross-party talks with the Conservatives and Liberal Democrats about its white paper proposals for reforming care. But those talks collapsed when the Tories ran 'death tax' posters about the plans to introduce a levy on estates to pay for better care.
And of course there was a Royal Commission on Long-term Care which reported in 1999, an ideal time politically and economically to make the big decisions needed. But the government sadly kicked the recommendations into the very long grass.
In short, commissions on funding care have not had a good track record. Anyone advocating another commission has to remember that firstly they have to come up with the right answers and secondly and more importantly the government has to be committed to implementing their recommendations.
So where does that leave us? It brings us back to where the power lies: the government.
We need government urgently to prioritise social care and its funding. We need government to take urgent action to ensure that the care system doesn't collapse in the short to medium term. And we need government to set out how it plans to make the system sustainable, fairer and simpler in the long run.
That is the job of government. We need to do more to make the government step up to the mark. But the growing care crisis and the growing awareness of the unfairnesses in the system will bring growing pressure to bear on the government.
Interestingly the Labour Party has just appointed a shadow cabinet member for mental and social care, giving the issues a much higher profile. The new shadow minister, Barbara Keeley, has the opportunity to show the government why and how it should act to tackle the care crisis.
Stephen Burke is director of United for All Ages and Good Care Guide
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