Warm words but scant hope from Dilnot

In general, the report on Social Care by the commission headed by economist Andrew Dilnot has been warmly received. But, as Sunil Peck suggests, concerns remain about whether the Government will deliver on Dilnot’s proposals

Activists who have spent years campaigning for a fairer social care system responded warmly to the publication of the Dilnot Commission’s report on how social care should be funded over the long term.

But the warning signs are that their initial optimism about recommendations, including the retention of disability benefits, national eligibility criteria for portable assessments and an increase in the means-tested threshold above which people have to pay for care, may turn out to be unfounded.

The Commission’s report is underpinned by the principle that nobody should lose all their assets to pay for their care. Instead it recommends a system in which the state picks up the tab once someone has paid a given amount for their care, somewhere between £25,000 and £50,000.

The report does not, as many campaigners would like to have seen, make proposals for introducing a system that provides free care to whoever needs it and which would be funded by general taxation.

In his statement to the Commons on the reform of social care, health secretary Andrew Lansley responded to the Dilnot Commission’s recommendations by calling them an “immensely valuable contribution to meeting the long-term challenge of an ageing population”. But he also said that reform needed to be considered against a backdrop of “constrained resources”.

Rich Watts, Director of Policy at Essex Coalition of Disabled People, remains “cautiously optimistic” that the recommendations will provide the basis for a fairer social care system.

“One concern, particularly before the last election, was that the work [on the future of social care] tended to focus on older people and people in residential care. It’s a huge step forward that Dilnot has said that the care system will be free for people who need support and who are under the age of 40 because that recognises the fact that those people can’t contribute to tax and national insurance because of institutional barriers linked to education and employment.”

Watts says that the other admirable aspect of the Dilnot Commission’s work is the recognition that inform­ation advice and guidance provided by professionals and people who have been through the system are vital elements of social care.

Both points are true. But anyone who attended a meeting where the All-Party Parliamentary Disability Group and other groups relating to age and disability convened to discuss the Dilnot report would find it hard to resist the conclusion that there are few prospects of the Government implementing many of the Dilnot Commission’s recommendations any time soon.

The shadow care services minister Emily Thornberry stressed Labour’s commit­ment to working with the Government to achieve a solution to the funding crisis. But as she put it: “One of the very big players in this is the Treasury and we’re concerned to hear unattributed briefings from the Treasury that the Dilnot [Report] will be strangled at birth.”

She went on to raise concerns that a white paper, which would come before a consultation period and any legislation, may not be out until Spring 2012.

Junior health minister Earl Howe said it was the Government’s ambition to publish a progress report on the issue of funding in early 2012.

He said that there were a number of issues that the Government had to consider alongside funding before it could publish a white paper.

“There are issues around how best to integrate health and social care, whether the proposals that we come forward with promote the personalisation agenda; there’s an issue around the levels of ambition we should set as to the quality of services we should expect to get from the system, whether the arrangements we have support the prevention agenda, how we can best promote a more diverse and responsive insurance market, and the cap and what level it should be set at.”

All those issues are relevant. But for all the rhetoric from politicians about the urgent need to fix a broken system, there’s no sense that anybody’s in a rush to do so.

Had the mainstream media not been distracted by the phone hacking scandal that broke at the time when the Dilnot Commission published its report, it’s possible that the issue of social care would have had more exposure, exerting more pressure on the Government to act on the recommendations more quickly.

But with the Treasury’s apparent unwillingness to invest in social care to the tune of 0.14 per cent of national income (a figure that Andrew Dilnot estimates would rise to approximately 0.22 per cent by 2025), we can expect to see another election, another report and more consultations before we can realistically look ahead to a transition to a fairer social care system.