Lord Victor Adebowale: Any single one of us could need social care, but how to pay?

We can't escape the fact that funding the very basics requires much more investment

Lord Victor Adebowale
Lord Victor Adebowale

The fact that the government's social care reforms have been pushed back until this autumn is a huge and frustrating disappointment.

Social care provision can no longer limp along in its current underfunded state. A long-term solution is needed urgently, one that results in the best support for the millions that need it, rather than leaving them with second best.

The indication is that the green paper will focus largely on the elderly, such as those with dementia or other age-related conditions. But they are not the only ones who desperately need guarantees. So do a million or so adults in the UK with learning disabilities, and more than 700,000 people with autism, including those supported by organisations such as Turning Point and many others within the voluntary, community and social enterprise sector.   

Yet too often they get overlooked in the debate about solving the current crisis, as do those with long-term mental-health issues. All deserve assurances that the support will be there, enabling them to enjoy independent and fulfilling lives.

If we are going to meet the needs of the most vulnerable in society, then proper investment is essential, especially in skilled and specialist staff. The question that successive governments have failed to answer, however, is where will this funding come from?

A report last week from MPs has called for the introduction of a social care "premium" to plug the current multi-billion-pound funding gap. The findings, published jointly by the committees for housing, communities and local government, and health and social care, suggest that people aged over 40 and their employers should pay into a special social insurance fund.

This approach is a step in the right direction. Raising taxes does not win elections, but we have to accept that social care will affect us all at some point, such as obtaining home visits for an elderly relative or assistance, or for a grown-up son or daughter with a learning disability.

My view is that all taxpayers should contribute, regardless of age but according to their means, towards social care funding if we are to have an equitable and fair system.

Another approach is a car insurance-type model as proposed by Damian Green, who was in charge of the yet-to-be-published social care reforms until his  resignation from the Cabinet. My concern is that this system would be inherently unfair because some people might not opt to purchase cover if the scheme was voluntary. Others would receive more or less support depending on the level of "cover" they could afford.

Then there is the inheritance tax approach, which Theresa May was forced to abandon. A manifesto pledge, this was seen as a way of charging social care costs against the value of someone's estate while they were alive. Tapping into housing wealth must be part of the solution, but it is vital that we don't leave people who don't own property behind, eligible only for very basic services.

Of course, the issue around social care is not just about funding, but also about how it is delivered. The danger is that more people end up in residential care because it is cheaper for local authorities instead of being supported to live independently in their own homes or in supported-living accommodation. This would be a massively retrograde step backwards towards more institutional forms of care.

With the right approach, we can transform the way in which social care benefits millions of people. In fact, I know we can because organisations such as Turning Point deliver change every day that alters the lives of individuals and communities for the good.

There is no escaping the fact that even to continue delivering the very basics involves more money. We face the choice of shouldering financial responsibility now or facing massive financial costs and human misery in the future. The alternative is to avoid some of this pain in the short term, but end up with a system that falls far short of our expectations in future. I know which option I would choose.

Lord Victor Adebowale is chief executive of Turning Point

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