Well, it turned out to be a summer of love for social care. Within just 10 days of taking office, the new Prime Minister, Andy Burnham, had wooed and wowed the care establishment with a no-notes speech pledging his passionate commitment to deliver reform where so many others, and once he himself, had failed over the past 30 years.
It was a bravura performance that won rave notices from all corners of the care sector. Although he announced little that had not already been set in train under his predecessor, it was his evident grasp of the issues, his movingly articulated personal experience and, above all, his clear resolve to get a reform plan at least on the table before the next general election that convinced most observers that here, at last, was the real McCoy.
There was something for everyone: recognition of the ‘roulette wheel’ of care costs, ‘as unfair as American healthcare’; an ambition, ‘in an ideal world’, that no one should have to sell their home to pay for their care; an aspiration to create over time a national care service to sit alongside the NHS and work ‘in a similar way’; an extension of eligibility for state-funded care to more of the 1.9 million older people in England who have needs but do not currently receive support; a commitment to uniform quality of care services; a pledge to improve pay, conditions and career prospects for care workers by beefing up the sector’s fair pay agreement process due to take effect in 2028; and a promise to prevent ‘profiteering’ by care providers, while offering reassurance that he was not seeking to exclude for-profit operators.
Therein lies the problem. In giving such a comprehensive, skilful summation of the many and varied shortcomings of social care, Burnham raised hopes across the piece – hopes that cannot possibly all be met, certainly not in one fell swoop or even, given how strapped for cash the Government is and will remain for the foreseeable future, not even in a whole succession of swoops.
Depending on what you include, a reform programme could cost anything between £7bn a year and £30bn. The media, already sniffing a ‘death tax’, seem to have alighted on a target figure of £18.5bn, calculated by the Health Foundation thinktank as the cost of making free all social care currently provided in England.
Baroness Louise Casey, looking on as Burnham spoke at a Jewish Care centre in north London, must have blanched. She had just agreed with him to bring forward delivery of the final report of her Independent Commission on Adult Social Care from 2028 to next summer. As she has stressed, that report will be shaped to a large degree by the findings of her ‘Big Conversation on Care’, a public consultation running until April through which she wants to hear the views of a million people. But she surely would have hoped for a firmer steer from the PM about priorities and benefited from it.
At the end of his speech, the Prime Minister took time to talk to people who receive care and support. He was relaxed and engaging and by general acclaim is good at such stuff. But is he quite so good at making the tough choices? We shall soon see.
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David Brindle is a social care commentator and former Public Services Editor of The Guardian.
Email: [email protected] Linkedin: @David-Brindle