Theresa May's dementia tax deserves the backlash it has received. It is a vindictive attempt to punish a select, unfortunate few for the crisis in social care exacerbated by the Conservative party since it took power in 2010. The policy's many defenders argue that it is wrong for less well off working people to subsidise the care of wealthy older Britons. Of the hypothetical example of a person with dementia staying alive for 10 years and losing all but £100,000 of their wealth, and another having a heart attack and passing on all their equally undeserved housing equity to their children, one newspaper columnist said those bemoaning the unfairness should get used to it. How easy it is to speak in such a way about a policy that doesn't affect you.
Some commentators are so wilfully ill-informed, such as Dominic Lawson in the Daily Mail, that they apparently believe family members don't look after their parents when they get Alzheimer's. They do, actually, spending years of their lives doing the job the state abdicated itself of responsibility for. Lawson, who presumably has benefited from an enormous inheritance, also believes the policy is fair and dismisses the argument around the cost of expensive medications the NHS bears on behalf of people who are ill, on the basis that what he calls "senile" care has never been covered by the health service. This is a lie. Privileged newspaper columnists are taking a perverse, vindictive satisfaction in the idea that people with dementia are getting their comeuppance for all the money their houses have made. Perhaps they would be happy to give up all but £100,000 of their wealth to fund vital services, or reverse benefit cuts that have hammered disabled people and the poorest in society.
You would not dream of forcing someone with cancer to use the value of their property to pay for drugs costing tens of thousands of pounds. It would be seen as grossly unfair and borderline immoral to make people going through a desperately difficult illness suffer further. Imagine the front pages, the public outcry. But apparently having dementia is somehow different. It is the responsibility of the person who gets this cruel, hideously terrible disease to pay for often poor-quality care to help them get dressed and use the toilet. Dementia is the leading cause of death in England and Wales. This makes it a health issue. The number of people with dementia is predicted to rise to one million by 2025, meaning more and more Britons will have their lives destroyed by an indiscriminate illness that removes their dignity, personality and life bit by bit until only a husk remains.
This is to say nothing of the 40,000 people under 65 who have early-onset dementia, who could expect to live, so to speak, with the disease for 10 years or more, paying for residential care costing as much as £50,000 a year. The message from the government is loud and clear: this is your fault and you are going to pay for it. No sane person would argue that social care is not in crisis and people who can pay should contribute, as they do already. My family has spent thousands of pounds on care in the home, my dad has all but given up his life to look after my mum, and I spend much of mine doing the same. We have saved the government hundreds of thousands of pounds already. But if it is going to take the same over again from us in the end regardless, where is the incentive to carry on doing the right thing? Families may just decide to dump relatives in substandard care homes, worsening the existing shortage of places, which will do nothing to resolve the social care crisis. This proposal will make people with dementia feel like even more of a burden. As for the "hard-working" taxpayers crying out that they should not have to fund care, I don't get to decide which aspects of the NHS my taxes pay for and whether they are worthy or not.
There are other solutions that appear to be more just, which share the risk out among the population, one of the principles on which the health service was founded. One is asking pensioners who can to make national insurance contributions, the other increasing inheritance tax. The Conservative manifesto hypocritically suggests the dementia tax is a means of redressing the wealth imbalance in society, but this sits awkwardly with an inheritance tax cut that allows houses worth up to £1million to be passed on without paying a penny. May's Britain is a country where the lucky prosper and the unlucky, ill and vulnerable suffer. Make sure you are on the right side.