How do we care?

Just before the summer recess, the Government published a Green Paper 'Shaping the Future of Care Together' proposing to develop a 'National Care Service' in the UK to make social care affordable for everyone.

In his foreword, Gordon Brown states that "A care and support system that reflects the needs of our times and meets our rising aspirations is achievable, but only if we are prepared to rise to the challenge of radical reform".

During 2008, the Government ran a six-month engagement process with the public, people who use services, and people who work in the care and support sector. Perhaps that was a sobering experience, because the DoH admits in this consultation paper that "There are wide variations in the standards and quantity of care and support offered by different local authorities. Such postcode lotteries are worsening as funding struggles to keep pace with rising numbers of older people in need of support".

The costs of care in the UK are phenomenal: a 65-year-old can expect to need care costing on average £30,000 during their retirement. Two in three women and one in two men will develop high care needs in their final years.

The one way in which a system could meet needs is through a universal, free at the point of need national care service funded through general taxation – it would also be the "radical reform" the Prime Minister claims to want.

The consultation paper looks at five funding options, the fifth of which is a tax-funded system. This is "ruled out because it places a heavy burden on people of working age". This has to be the most illogical statement ever made. If that burden is heavy when spread across the entire working population, then how 'heavy' will it be when placed solely upon those who actually need care? The paper also stops short of suggesting care home accommodation costs should be met, which will impose another cost on older people.

However, it is entirely consistent with the New Labour agenda against universalism and towards co-payment, means-testing and stigmatisation – across the board from benefits to pensions. As part of that agenda it is proposed that non-means tested, needs-based Attendance Allowance and Disability Living Allowance would be used to fund a national care service. However, these benefits enable individuals to pay for extra living expenses, not basic care.

The National Pensioners Convention states that therefore the Green Paper "does not meet our concerns". In response the NPC has instead presented an alternative vision of a National Care Service, and is building alliances with others to forcefully put the case for truly fair system – the only fair system.

Social care is an issue that, like healthcare and pensions, will affect us all. Universalism is the only way forward – and trade unions also need to be fighting alongside the NPC and carers’ organisations for this approach. A National Care Service could then be as emblematic as the National Health Service.

This approach is also advocated by Age Concern and Help the Aged, "high quality care must be available to all who need it regardless of where they live and whether they are rich or poor" according to their Director Michelle Mitchell.

The consultation on the Green Paper runs until 13th November 2009, and can be downloaded from the Department of Health website.