Another week, another flurry of evidence about the care crisis across the country.
Everyone seems to agree that there is a crisis, that care is massively underfunded, and that the problems are only going to get worse as demands increase because of our ageing population.
Now that this diagnosis is widely accepted, it's time to do something about the crisis and time for leadership nationally and locally.
Here are three things that government could lead on and do more to encourage local action:
1)Take immediate action in the Budget to deal with the current crisis
Government needs to provide additional emergency funding in March's Budget to relieve the pressures on hospitals and bolster hard-pressed care and GP services. The growing number of older people, particularly aged over 80, languishing in A&E and hospital beds must be urgently reduced. The government points to variations between areas in care practice and it's crucial that we learn from the best about what can be done to keep people at home and out of hospital. That will also include involving voluntary organisations delivering neighbourhood support on discharge and preventative care. Reducing the variations in care practice and spending could improve quality of life for many older people and save significant amounts of funding.
2)Introduce system change across health, care and housing
I have written many times about the need for radical change. Not just more integration along current lines, but creating one system of health and care, funded in the same way through taxation and led, delivered and commissioned by one body locally within a national framework. The sustainability and transformation plans fall a long way short of achieving that full integration. They require central government to take the lead on strategic direction. Housing must also be part of the picture for two obvious reasons: we need homes that are suitable and appropriate for lifelong living whatever an older person's needs; and the housing costs of older people - except for the poorest - will never be the state's responsibility but housing wealth could be much better used to support many people in later life.
3)Create a society fit for our ageing population
Following on from the above, only government can join up and create the vision and framework for a society that meets the needs of our ageing population. As life expectancy continues to rise, this means looking at the whole of later life - from retirement from work and new forms of work, pensionable age and pension provision, paying for care and health, and older people's contributions to their families as carers, to their communities as volunteers and to our wider society. Clearly this must be debated across society and by people of all ages. Britain is one of the wealthiest countries in the world and between us we should be able to afford better services and quality of later life now while guaranteeing the same for future generations. That will also mean more fairly taxing the wealthiest older people.
As the government grapples with the enormity of Brexit, we also need to focus on what kind of country we want to build post-Brexit. A country for older people for generations to come should be part of that vision. Action to make it happen must start now before the care crisis becomes catastrophic.