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What's The Big Vision For Care For Older and Disabled People?

28/03/2017 13:44
JACK TAYLOR via Getty Images

Council tax bills have landed on doormats and across the country most households face higher charges to pay for care for older and disabled people.

But we all know that this will only be a sticking plaster on a care system in crisis. It's not just woefully underfunded, but the care system is failing in so many ways to prevent crisis, support independent lives and provide real quality of life in people's own homes.

We shouldn't despair completely. The government has promised a green paper which will review how care is funded and how it will be delivered, looking at examples from other countries as well as revisiting the conclusions of previous inquiries and commissions.

Let's hope the government's intent is genuine and this is not another delaying tactic, yet again kicking the care issue into the long grass.

One mistake already made has been to start with a discussion on how to raise more money to fund better care. This has led to the Chancellor ruling out in his Budget on 8 March the possibility of a levy or duty on estates, aka the death tax.

But haven't we got things the wrong way round? For example, when the government decides to spend more on childcare (as it is now doing), we don't face demands for a 'birth tax'. And similarly with other government spending priorities from defence to Brexit, the first question isn't 'where is the money coming from?' - it's all about what we as a country need, not how to fund it.

Surely we need to start the green paper with a vision for a care system, fit for the 21st century and all our aspirations for a decent later life? What do we want from a better care system?

We need to go back to basics on the key principles and purposes of a new care system, involving care users and their families.

The green paper needs an open and transparent process whereby citizens can contribute to the vision and the principles. At the moment the review seems a rather shadowy Cabinet Office exercise.

We must be ambitious for the future, thinking big and not simply accepting more tweaking of a failing care system.

Four particular principles I would like to see underpinning a new care system are:

- Universality - everyone should be able to get something from the care system and therefore will be prepared to share the risks and costs of that system.

- Planning ahead - thinking about care we might need and want towards the end of life should involve us all focusing on what we do about prevention, housing, advance directives and so on, so that we remain in control of our health and our care.

- Sustainability - clearly more money is needed but we need to make much more of all the people involved if we are to build a care system that lasts - from those using care and their families and carers to the care and health workforce. Care after all is (still) very much a people business.

- Mainstreaming care - care should be everybody's business and a key part of our economic and social infrastructure. That means not just integration with housing and health, but also involving everyone from employers and schools to planning and development agencies.

No doubt others will have key principles we should incorporate. In future blogs, I will return to the issues of how we fund care. But let's get the vision right first and let's think big.

Stephen Burke is director of United for All Ages and Good Care Guide

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