The government’s taxing position on social care
Many people support the cost of social care being met through taxation – so why is the government dismissing this approach?
Whatever happened to the government mantras of “thinking the unthinkable” and “thinking outside the box”? The new social care green paper is charged with the vital task of setting out possible approaches to put social care on a sound financial footing for the future. Yet while almost every other financial possibility has been ruled in, the one option the government categorically states that it is ruling out is funding social care through general taxation.
The green paper itself says: “Many people told us that they thought an NHS-style system, where the full costs of care and support were met through taxation (ie it was provided to people free when they needed it) would be the fairest option.”
So what’s the argument for dismissing this popular and effective approach? As the green paper puts it:
In this system, people would pay tax throughout their lives, which would be used to pay for all the people who currently need care. When, in turn, people needed care themselves, they would get all their basic care free. This system would work for people of all ages. This is ruled out because it places a heavy burden on people of working age.
So the Orwellian argument from the government for rejecting the only funding arrangement that could helpfully unify health and social care, and at last put them on an equal footing, is that it would be inequitable and unfair – despite “many people” telling the government exactly the opposite.
The assumptions that funding social care through general taxation would set the generations against each other would benefit from critical consideration, as they seem to rest on outmoded and narrowly-based understandings.
Social care meets the needs of a large and growing number of people of working age, as well as the expected needs of a growing number and proportion of older people. Good social care can also make it possible for many people of working age to return to employment, and increase the taxation contribution in this way. Older people are taxpayers too and contribute in many other ways, such as through the provision of childcare and informal support. Increasingly, we are told they will need to stay longer in paid employment.
At the green paper launch, I asked the lead civil servant involved, David Behan, the Depatment of Health’s director general for social care, why the option that a wide range of service users repeatedly argued for was rejected outright when so many other options with a limited evidence base were being included. He restated the argument about the need for intergenerational equity and fairness, but said that he knew that service users and their organisations would raise this issue in the consultation linked with the green paper.
Did this mean that funding from general taxation could be ruled in again? Behan replied that he knew that service users such as me and our organisations would be making these points.
Knowing that the government has already heard from many people that funding from general taxation is their preferred option, and comparing the strength and resources of cash-strapped service user organisations with the other powerful interests operating in this field, it is difficult not to have doubts about the genuineness and transparency of the “big care debate” the government is initiating. Some serious reassurances are now needed.