Another hard hitting from Polly at The Guardian … interlocks with other threads but this one can stand alone
… change of plan …also posted in the main GREEN PAPER thread :
**Care for the elderly is a scandal – but don’t expect a solution from Hunt or Johnson.
Elderly people are left home alone dying needlessly because of austerity. It’s time to tax Britain’s soaring property wealth.**
Social care services are in freefall, with tens of thousands of people getting no help at all. What’s new? This week’s withering assessment from local authority directors of adult social services in England brings yet more evidence of the unfolding disaster hidden behind the lace curtains of 1.4 million neglected old people, home alone. More than 54,000 people have died waiting for care services that never came. Lip service is paid, nothing is done.
There is a fiction that an ever-disappearing green paper, six times cancelled, will solve the problem. That’s a hollow hope: expect no more than a few hazy options, though even these are too politically frightening to see the light of day. Among the Tory leadership candidates, Jeremy Hunt made a token nod that cuts went too far, but care doesn’t feature in his eye-watering list of tax cuts and defence spending plans. Boris Johnson hasn’t mentioned it: he probably doesn’t know what it is.
Pressure on care services has been stretched to breaking point since 2010, with local authorities stripped of nearly half their funds, and the numbers in need soaring. A third of councils have seen some residential homes close, nearly half have had home care services collapse with no cash to cover the rising minimum wage for staff. Day centres and meals on wheels are now vanishingly rare. Wait for the “forthcoming spending review”, says the department, but councils would be advised to keep their expectations extremely low.
Reports and commissions analysing the problem have poured out, with the basic solution staring everyone in the face. But the political facts of life make the answers unpalatable, because they reach deep into the maldistribution of everything in the economy.
Here’s the problem: currently care is means tested. People start paying for home care when savings reach £23,000. If they go into residential care, the value of their home is taken into account too: families often have to sell up to pay. That causes outrage as few people are aware of the pitfalls until a family needs care. Middle-aged offspring see inheritances eaten away, when most assumed care was as free as the NHS.
The injustice they see is the randomness: lucky if you drop dead fast and need no care, financially crippling if you linger on with dementia in a care home. Any just system would even out the risk and the costs, so the sick are not penalised.
But remember the “dementia tax” row that helped to shipwreck Theresa May’s 2017 election. Bravely raising money for the devastated care system, her manifesto threatened to take the value of property into account in paying for home care, as well as residential care – to the outrage of Tories and the press. She retreated and promised the green paper that never seems to appear.
What would a just system look like?
Everyone would get the same quality of care at the point of need, as in the NHS.
Where should the money come from? Not from general taxation, where the working young are already burdened with the cost of the baby-boom generation’s healthcare. They already struggle, earning less than their parents at the same age, with fewer able to buy a home and rents rising. Wealth has accumulated among the elderly in properties denied to the young – that property wealth should be drawn on to pay rising social care costs.
But any new plan has to be carried out fairly, with people paying according to their means, and able to predict the cost of their contributions – pooling risk and removing the random nature of the current system. Labour’s 2010 manifesto had the right idea: on retirement everyone would pay a lump sum into the pot according to their wealth and income, which could be a lien on their home to be paid with interest after death, just like with equity release. As at present, the state would pay for those with virtually no assets.
However, as with May’s manifesto, that plan caused uproar and was branded a “death tax” by the Tories. Fair, predictable, removing risk and redressing some of the intergenerational divide, it was blown out of the water. Why? Because any further encroachment on property or inheritance is anathema to Tories, which is why the green paper never emerges. Everyone knows the property wealth of the elderly must be tapped, but the government dare not whisper it.
There are lots of excellent arguments made for creative ways to tax ever-rising property wealth, but they often encounter rabid opposition. This month Labour published an admirable discussion paper, Land for the Many, written by George Monbiot and others, proposing land value taxation. But read the double page spread in the Mail on Sunday for a flavour of the fury such solutions face: “Corbyn war on homeowners”. The paper’s finance editor was incandescent: “Spiteful raid that will horrify millions”. The sentiments in the Express, Sun and the rest were identical.
Some call for cross-party collaboration. Labour tried that but David Cameron pulled his people out of the committee just before the 2010 election to unjustly attack as a “death tax” the very things his own participants were on the point of agreeing. Labour’s attack on May’s “dementia tax” was equally shortsighted – but in the heat of elections, parties use any weapon. For any government to grasp this nettle needs careful preparation, with a royal commission and a citizen’s assembly to thoroughly air the problems, spread the facts and win consent.
Would Johnson or Hunt? Not a chance. The best councils can hope for is a bit of sticking plaster, an emergency bung now and then, but no ambitious long-term solution. Neither future prime minister is a brave, good or far-sighted man, that much we know.
• Polly Toynbee is a Guardian columnist