Assessing the new social care white paper

Professor Jon Glasby

“Everyone thought the social care White Paper would be underwhelming – but the way it was launched spoke volumes.

All week, the focus had been on Lords reform, with every nuance, implication and recrimination reported in detail.  On Wednesday, Prime Minister’s Questions was its usual bustling, rowdy self.  At the end, the Health Secretary stood up to launch the White Paper, but had to wait before he could speak for almost all the MPs to leave.  When he was finally able to start, he spoke to an almost empty House, and he looked embarrasses almost throughout.

After years of neglect by successive governments, it’s hard to think of an issue more pressing than the funding of adult social care.  Several reviews have been conducted and largely ignored, and the scale of the problem has continued to grow.  Everyone agrees that the current system is fundamentally broken, but no one seems able to reach consensus on how it should be fixed (and who should pay for it).  Stuck in the middle are millions of older and disabled people and their families, who feel lost, confused, angry and let down.

The most recent review – by Andrew Dilnot – was impressive.  Given a very narrow brief, he nevertheless produced a report which was well crafted, well pitched and well founded.  The actual proposals were relatively modest – and not very expensive in the overall scheme of things.  However, the report was designed with something for everyone – and to be capable of being implemented in practical terms in the current policy and financial context.  If anything could bring together some of the bitterly opposed views, then this was it.

Despite agreeing to the principles of the Dilnot report, the underlying impression is of an attempt – presumably by the Treasury – to kick the issue into the long grass (again).  There are some positive measures, but these are weak and merely tinker around the edges of a system already bursting at the seams.  Older people deserve better than this – and they deserve to have their MPs and political leaders actually turn up, grapple with the key issues and try to find a way through.  This takes political courage, a long-term view of success and a fundamental willingness to do the right thing in difficult circumstances – not a half-finished White Paper being launched to a nearly empty room.

Of course, as the population ages, the political power of older people will increase.  It may be that policy makers one day come to regret the lack of foresight they showed yesterday.”

Jon Glasby is Professor of Health and Social Care and Director of the Health Services Management Centre at the University of Birmingham.

In 2010, he conducted a review for Downing Street on the future reform and funding of adult social care (