Last year, on the 75th anniversary of the Beveridge report, the respected Financial Times journalist and author Nicholas Timmins pondered the question ‘what if Beveridge was reporting today?’
He concluded, rightly in my opinion, that Beveridge would be totally bemused by the separate NHS and social care systems that successive Governments have presided over. The separate funding models, the separate entitlements to care, would undoubtedly lead Beveridge to the conclusion that now is the time for action.
However, what I think would give the great reformer the most cause for concern would be this generation of politicians’ resistance to reaching a long-term funding settlement for social care.
In 2010, as part of cross-party talks on social care, I tried to grasp this nettle and proposed a comprehensive reform - where everybody contributes, and everybody is covered. This would mean that everyone could get access to the care they need whether that is access to residential care homes, home adaptations, home help, supported living or the many other types of social care services.
The Conservatives responded by putting up posters saying: “Now Gordon wants £20,000 when you die.”
We’ll never know exactly what effect those posters had on my party’s election prospects in 2010, but I do know the chilling effect they had on the social care debate. They instantly killed any talk of reform and buried the debate for years to come.
Rumours are now circulating of yet another delay to the long awaited social care green paper. If true, it would mean that since it was first promised in March 2017, the green paper has been pushed back six times.
Each delay leads to a greater number of older or disabled people having to face a terrible dilemma. Either they must deal with bills that could wipe out everything that they have worked and saved for over a lifetime or they must go without the care they so desperately need. The fact that people in this country are facing this choice shows how we have failed the ambitions that Beveridge set out.
In Greater Manchester, we are pioneering a new model of public service delivery – going further and faster than anywhere else in the country. But we are reaching the limits of what we can do without a long-term settlement for social care. Strong local relationships and legislative work-arounds only get you so far.
A system which provides medical care for free but requires people to pay for their own social care will never be truly preventative or allow us to care for the whole person. More importantly, it will never deliver fairness.
My test is simple – we won’t have a 21st Century ready NHS until it supports people with dementia as well as it treats cancer.
The good news is that new, progressive thinking is gaining traction - most recently from IPPR’s independent review of health and care led by Lord Ara Darzi. That ground-breaking review rightly concluded that: “If social care were a medicine, it would be NICE approved.”
The truth is our failure to properly resource and reform social care is not a down to a lack of money but ultimately, a lack of political will.
With a growing and ageing population, it is time we recognised that high quality social care cannot be a luxury. It must be an entitlement provided by a civilised society.
So my message to this Government is clear – be as bold as Beveridge.
The time for action is now.
Andy Burnham is Mayor of Greater Manchester and was Secretary of State for Health 2009-10. He is speaking on social care at an IPPR conference on Wednesday 14 November