It’s time to create a National Care Service for us all, says SUSIE BONIFACE
Politicians really do not want to talk about tax rises or end-of-life care. Instead they like to promise tax cuts, and pretend voters will live for ever.
Which is why our social care system runs on love. Carers UK says 600 people a day give up work to care for someone. A million care for more than one person. If you’re a woman over 50, you’re more likely to be a carer than anyone else – out of work, living on savings, and getting ill with stress.
Their commitment is worth about £132billion to the economy, according to the Carers Trust. Those aged over 80 provide an astonishing £23billion-worth of care. The Government spends just £16billion.
And since 2010 that’s been salami-sliced by cuts, which means local authorities have had to make “efficiency savings” of almost £8billion.
But we’re not dying efficiently enough. If we’re lucky we get old, might have things wrong, but live with them for years.
If you own a house, pray you don’t get dementia. It’s the most expensive care of all and anyone with more than £23,250 of assets has to cash them in. The number of us with dementia will have doubled to two million by 2050.
The amount we spend on care should be increasing. Instead, Britain treats those who need help like rubbish.
Of 5,200 requests for social care made to local authorities every day, 25 percent are turned down. Age UK thinks there are 1.5 million people with an unmet need for help with washing, dressing, or using the toilet.
A growing number of them are not the old but those who, thanks to medical advances, have survived into adulthood with complex problems, or have conditions science has only recently been able to diagnose, such as autism.
It’s not just the sick who need help. Around 2.4 million people form the “sandwich generation” of those caring for both parents and children. Worried relatives have to navigate a nightmarish system without any idea what they’re entitled to, or how to get it.
They might get the £66.15-a-week Carers’ Allowance. But they might also get taxed on it, lose other benefits or lose their job. Almost three quarters will become mentally ill, and 61 percent physically so.
But a source of shame and misery could be turned into a matter of national pride, with a National Care Service.
The care timebomb was spotted as long ago as 1999 when a Royal Commission recommended all personal care should be state-funded.
In 2010, Gordon Brown’s manifesto pledged free help with getting out of bed, washing, dressing and eating. Yet now Boris Johnson promises only to talk about it.
The economic benefits would be huge. About five million carers could work more, save more, spend more. They’d have their burden lifted, be happier and healthier.
The NHS would discharge patients sooner, freeing up beds and staff. The care service and the health service could dovetail, keeping people at home for longer. There’d be fewer falls, fewer visits to A&E. Fewer GP and ambulance call-outs.
There would be support for patients and relatives. Clear pathways to benefits and expertise. There could be more training for professional carers, and by removing the profit motive of companies that – says Manchester University – try to make a 12 percent return on every patient, they might get more than 15 minutes to spend with each one.
Perhaps most importantly, there would be respect – for those who need care, and those who give it. We could still care for our loved ones if we wish, but with help.
This is not a luxury.
A third of people aged 35 to 45 don’t own a home, and won’t have one to sell in old age. Those caring for others will need help themselves one day, and families aren’t always around – often they live many miles apart. This need will only grow.
At present, the wealthier are being overcharged while the poorer aren’t getting what they need. How much better if everyone had a basic level of dignity so they could live independently, or stay in work.
And the cost is not prohibitive. Before the election, the King’s Fund calculated it would be £6billion – or about 18 and a half miles of HS2.
A 1p rise in income tax could cover it. Politicians are just too reluctant to talk about taxes and death – no matter how inevitable both are.
Social care is unfashionable and invisible, but it’s vital. A National Care Service would be decent, humane, and provide huge social capital.