The (several) billion-dollar question – more tax for better social care?
Dan Smith, Chief Executive Officer
Amid the jokes, tears and cheers of Andy Burnham's conference speech this week, the British public was again the hopeful payee of more of Labour's post-dated cheques, and few would bet against many of them bouncing. The Prime Minister promised a “National Care Service, fully funded and not through borrowing” if Labour wins the next general election and made a downpayment on his flagship commitment by watering down the triple lock. So while we might avoid bankrupting the country through an ever-increasing pension liability, we’ll have a new state-funded body capable of swallowing billions of taxpayers' money instead. And there’s only one place the money can come from - as I so presciently mentioned in a recent post, the PM will be campaigning at the next election on a manifesto promising a significant tax rise: an unconventional approach by any measure.
He also reiterated that the thinking on what this new service might look like has been delegated to Baroness Casey as chair of the Independent Commission on Adult Social Care, due to report on its findings next summer. She has recently made comments about large, often overseas-owned organisations in the sector “profiteering out of human misery and human life,” and I’m concerned that emotive language like that coming from the person shaping the new system gives a clue as to where the commission's thinking is heading. Casey has however acknowledged the role that the private sector will have to play and it’s clear that any new service has to be conscious of the risks of crowding out private capital which can price and bear the risks of developing, building and operating care businesses.
The social care system is clearly not working. The issues are numerous and complex: hospitals should not be an undignified holding bay for the elderly, care staff should be entitled to decent pay and there shouldn’t be a care lottery for diseases such as dementia. But voters should be aware that the new National Care Service that the PM is championing and that the Health Foundation estimates to cost £18bn won’t be the panacea we all might hope for. This won’t be covering the cost of residential care for all of us but will rather aim to keep the elderly out of hospital (and care homes) by looking after them better at home.
In the meantime, the government looks to be treading water and remains hemmed in by its 2024 manifesto promises. The PM’s speech made no intelligible mention that I could see of any plans to reduce the deficit, to control the welfare budget, or indeed to drive economic growth. It does rather beg the question as to the point of this government now (notwithstanding the better TikTok videos) and whether the electorate will buy into his vision for increased taxes to pay for an improved social care system. While Andy Burnham might like to keep on writing his cheques, do we want to cash them?
