With a government green paper on reforming care due this summer, expectations are mixed.
Some see this as the best and only opportunity to fix the beleaguered care system. The latest care report from the National Audit Office warns of a Cinderella service in danger of collapse.
Others fear at a time of Brexit and continuing austerity that the green paper will just offer more tinkering and sticking plaster with no meaningful long-term reform let alone extra funding.
So what should campaigners do to get the best outcome from the green paper and beyond?
First is setting the terms of the debate. Rather than beginning with how care should be paid for, we need a new vision for care. No other public policy debate starts with how to pay for it, we must be clear about what we need first.
The vision has to start from where we are now and the failings of the current care system. The problems then point to five principles for a new system - it needs to be:
FAIR – from a lottery depending where you live to care you need whatever your circumstances
SIMPLE – from complex and confusing to simple and easy to use when and where you need care
PERSONAL – from one size fits all to care that starts from who you are and how you want to live
SUSTAINABLE – from growing unmet needs to well resourced quality care, managing demand
UNIVERSAL – from helping some people to helping everyone with their care needs
So a new care system should be fair, simple, personal, sustainable and universal. To deliver this requires some key building blocks:
- a national framework for care and health that guarantees quality care for all across the country, with a single local body that commissions and delivers care
- a focus on prevention not just crisis care, managing demand and transforming the way care is delivered using technology, self-care and a skilled and valued workforce
- a 10 year plan for making it happen for this and future generations
A cost-benefit analysis of this vision and plan for a new care system could provide the ammunition to secure investment from the Treasury in the next spending review.
A tax-funded system is the fairest way to pay for joined up care and health and to share the risks and costs of care we may all face. It’s up to politicians to decide on the best way to raise the necessary tax revenue – from income tax on working adults or for example from a wealth tax on those who can most afford it.
To achieve this vision, we need bold leadership. Leadership from the top of government – the Prime Minister, Chancellor and Secretary of State for Health and Social Care. Leadership from all the key partners and stakeholders in the care and health system. And leadership from all those who need better care – older and disabled people, their families and carers, and the care and health workforce.
Reformed care and health are key parts of our social and economic infrastructure. They are crucial to the future of this country and the well-being of all families. We must not duck this challenge.