It seems likely that social care in Britain will drift from crisis to crisis for the next five years. What might be done to improve this?
British politics is still trying to recalibrate after the December election results. The Labour party is occupied with choosing a new leader, and in that process, choosing some new strategies and policies. The Conservative party are in government and have expelled many former centrist members from parliament. The snake oil of Brexit has been buried for the moment, but it will resurface around July when reality kicks in again.
So, possibly the biggest policy challenge for the government aside from Brexit is social care, and unlike Brexit it cannot be avoided as the pressures within the NHS continue to tear health and social care apart. The policy position of the government on social care is that it wants a cross-party policy consensus, but where the different parties have widely different positions. In short, the conservatives want a market solution while labour wants a public service. So a consensus isn’t possible on the structure, even before we consider how to pay for the structure.
Currently the toxic element is how to fund social care. Public sector spending by councils and in community care has fallen by an estimated 21% in the last ten years. Theresa May tried to suggest a means-tested approach during the 2017 election campaign and it blew up in her hands. The normally supportive right-wing press jumped on the “death tax” slogan because owner-occupiers would have to pay off their social care debt from their estate after they had died, usually by selling the former home.
So, barring a big change in policy by one of the main parties, social care policy looks likely to languish until 2025 or longer. What can we do about that?
Looking at some of the early pioneers in the 1960s, 70s and 80s in England, some disabled people did manage to create their own social care solution and leave hospital wards and charity homes to live in the community in flats and houses. Examples include Pamela La Fane, Ken Davis and Maggie Hines (Davis), John Evans, Margaret Wymer, June Maeltzer, and no doubt others.
Each solution was person-centred and often a creative mix of funding and mutualism. Housing association funding was sometimes stretched to its limits, as were local authority support and resources. More than once the lawyers had to be called in to confirm a solution was lawful.
Many in the Labour party are calling for more local activism as a strategy to rebuilding support. The usually examples of local activism tend to include things like running a food bank, an advice centre, organising litter picking days, writing leaflets and newsletters and very-local social media groups, meals and bingo sessions for pensioners.
A question for the moment is how might such local activism support new social care solutions? And not just more bingo.