Suspend cynicism in social care – Richard Humphries

After an election campaign in which social care failed to register on the political radar, its inclusion in the coalition’s programme for government will be welcomed.

The significance of recognising an urgent need to reform the social care system should not be underestimated.

The resulting pledge is to establish an independent commission that will consider a range of ideas. These include both a voluntary insurance scheme to protect the assets of those who go into residential care, and a partnership between the state and individuals, as recommended by Sir Derek Wanless in his original review of social care for the King’s Fund in 2006.

Any cynicism that this reflects the time-honoured Whitehall tradition of using a commission as a device for delay and distraction should be suspended. The commission will report within a year and, of course, the underlying issues will not go away.

This offers a real opportunity to re-oxygenate the debate about how we pay for long-term care and create a fresh platform for change. But the tasks faced by the commission are formidable.

First, its terms of reference and modus operandi must command confidence and credibility. Much of the spadework has been done – the King’s Fund’s recent reassessment of funding options is the latest in a long line of reports that will offer the commission a head start.

The second challenge is how it will traverse the dividing lines – notably between compulsory and voluntary approaches, and which scuppered efforts at pre-election bridge building – and craft a set of proposals that will generate consensus and a foundation for sustainable reform. A government that owes its existence to coalition and compromise needs to be able to respond to this.

Finally, unlike its 1999 predecessor, this commission will conduct its work against the most inauspicious financial climate facing public services since the 1970s. Caught between a fiscal rock and a demographic hard place, making the case for the affordability of a reformed system will be crucial.

The abandonment of the free personal care at home proposals will offer some temporary fiscal respite for cash-strapped councils, but from 2011 the pressures will intensify. And there is no sign that the budget protection afforded to the NHS will be extended to social care. That the immediate prospects are so grim underline the importance of the commission’s work – and the political response that must follow.

Richard Humphries, social care fellow at the King’s Fund,