Dilnot: more questions than answers

The Dilnot report on social care follows its predecessors, says Peter White, in failing to deliver definitive solutions

The swish of long grass has been heard accompanying Andrew Dilnot’s long-awaited report on social care (all reports on social care are long-awaited and are always followed by more of the same).

Mr Dilnot is a clever and, I imagine, compassionate economist, but must have known he was operating in a political climate where some things aren’t worth saying. So, for example it’s worth saying that with the huge inflation in house prices in recent years, it makes sense to raise the savings threshold you can amass before you dig into your own money.

Similarly, it was worth saying that there ought to be a limit to the amount you paid out for your care once you’d passed that threshold, so that people with severe needs weren’t ruined by care costs.

What it wasn’t worth talking about, and hardly got a mention in the report, was the idea of a national care service, one that assessed need based on national criteria, and dealt with at the point of need.

Ring a bell? Yes, a bit like the National Health Service, a concept that, in spite of everything, has some­how managed to survive in recognisable form and do to a remarkable extent the job it was set up to do in 1948.

The fact that on this occasion this was unsayable meant that when I prepared to question Mr Dilnot about it on the radio, I knew I was opening myself up to the charge of naiveté, even though Scotland has been doing something like this for a decade. (People mutter darkly that it’s not working, without ever saying why not.)

The fact is that the social care elephant-in-the-room is geography. Over the past few years we’ve seen huge variations from one local authority to another about who ought to receive help. Increasingly, and under admitted financial pressures, local councils have raised the bar of eligibility for receiving basic help, until we’ve reached the point where often the only definition of need that will qualify you is “critical”.

Imagine if that situation was replicated in the NHS, and each local area left to decide what illnesses could be treated, and at what level. But in the area of social care in England, that’s how it’s always been, leading to situations where people already on their uppers are paying for the fundamental services that make their life worth living.

Dilnot, though meticulous and politically safe, had a chance to take a stand on such distinctions. He failed. No matter! The report will be dragged through much long grass before anything changes! Meanwhile, the demographic timebomb that makes it necessary rolls irrevocably on.