The language and liklihood of consensus – can there be a cross-party solution to social care?
If any consensus exists on the state of our social care system, it is this: it is in crisis. Scandal, emergency, calamity – whatever word is thrown around to describe it, we are left in no doubt about the grave challenges we face if we are to restore quality, adequately funded care to our ageing, disabled and vulnerable populations.
Our new Prime Minister, Boris Johnson, has recognised this “crisis,” and promised to fix it “once and for all.” This is a welcome statement, and he is right to identify this as a key priority. He is right to say that nobody should be forced to sell their home to pay for care. And he is right to demand a cross-party solution, because this is a huge crisis that requires widespread and well thought-out reform. Yet, regrettably, I am sceptical about how likely a cross-party solution is, and mystified as to what it might look like in reality.
Consensus is important. This is an issue that requires us, as a country, to rise above partisan disputes and ideological red lines in order to find a workable solution that delivers the best for patients and families across the country. However, I am not sure Mr Johnson or Mr Hancock have got us off to the best start.
Firstly, consensus building requires constructive, open discussion. For Johnson to suggest in the Commons that the Labour party is “not interested” in addressing the social care crisis, and that if this is the case the Conservatives can “fix it ourselves,” was, in my view, counter-productive rhetoric. It felt like a churlish and partisan dig at his counterpart. Building consensus must start with an invitation, not a challenge.
Johnson’s remark reminded me of Matt Hancock earlier this month blaming the absence of the long-awaited and long-delayed social care green paper on the “lack of cross-party consensus”. He essentially blamed other parties for his own department’s failure to propose any tangible policy. I found this, frankly, absurd. A green paper is the basis for a government to set out proposals upon which it seeks further discussion. No consensus can be built without an initial idea to discuss. Perhaps Mr Hancock was too busy playing with his cool new toys and forgot that it was he himself who was responsible for the green paper. At least care minister Caroline Dineage has expressed some regret at the paper’s delay.
This is not a partisan rant at those in power. It is a point about the language of consensus building. Indeed the Labour Party, particularly its leadership, must do more to bridge divides across Parliament and to find areas of compromise. The blame games, and political point-scoring, from all sides, must stop if we are to fix the social care crisis. I am not sure they will. The age of tribalism is upon us.
But even if the language changed and the partisan games ceased; even if there was some path forward through positive and constructive discussions – how likely, in reality, is a solution coming from all sides of the House?
One issue is the parliamentary logjam we have been stuck in for three years. With MPs busy shouting at each other and the mirror about Brexit, the chance of any impactful domestic policy emanating from Parliament seems scarily slim. This is understandable to some extent, for how can we embark on large-scale funding reform (of any sector) without any inkling as to what the state of our country’s finances will be in 100 days’ time?
Another is the trauma of 20 years of inaction and failed policymaking on social care. LaingBuisson founder William Laing was pessimistic about a cross-party solution on Radio 4. He believes it will not happen because that is what history has shown us over the last two decades. He may well be right. The ‘death tax,’ the ‘dementia tax,’ Cameron’s costs cap that never was worn. They all linger like spectres. Of course policymakers are hesitant. They are haunted by decades of divisive and unpopular proposals.
We must consider what such a consensus would look like. This is not easy. Proposals for an insurance model have been deemed unworkable by the Lords, and the Conservatives would surely roundly reject Labour’s National Care Service. Policymakers must also reconsider their priorities in relation to this sector. I am all for technological advancement in care and excited about its potential benefits. But when 14% of older people have basic unmet care needs, it may be time to put dreams of care robots and large-scale digital transformation to one side. Sorry, Matt.
Moreover, if £8 billion is needed merely to restore quality and access to the levels of 2009/10 (according to the Lords/King’s Fund/Health Foundation), how much investment and reform is needed to create a care service that does not just do the bare minimum? How much is needed to create a modern, affordable social care model that delivers on patients’ needs, makes the most of technology and boasts a skilled, valued and well-paid workforce?
Probably a lot. At the height of a crisis and after decades of failed reform, a cross-party solution that starts by identifying a workable funding model is the only way forward. Then the other big questions can follow.
Crossing parties means building bridges, which is not our Prime Minister’s strong point. It may be a long and arduous road to a solution to this crisis. But a solution is there to be found, so let’s all find it together.
Best of luck, Boris
Edward Boyson is an Account Executive at PLMR, a communications agency specialising in the health and social care sector, offering expertise in media relations, planning, digital marketing and public affairs.