A political consensus is emerging here at Westminster about what has to be done to save the NHS which we all know is in crisis. The main cause that has been targeted is social care, which has been created by an ageing population and yes, cuts to local Government. Jeremy Hunt has now persuaded the Prime Minister to bring social care into the NHS, which is a good thing, but in my books the budget, which currently sits at the Ministry for Housing, Communities and Local Government also needs to be transferred. The NHS rather than councils should be in charge of commissioning social care.
As we all know old age is a condition lottery; one person might require £100,000 of care, another £20,000. Is it not a fairer solution to pool the risk between as many people as we can so that everyone loses something but nobody loses everything?
In my view the so called ‘dementia tax’ was a good manifesto pledge because it suggested those who own their homes contribute to their own care rather than allowing our children and grandchildren, who are finding it difficult to get on the property ladder themselves, to pay for it. But it was flawed because it didn’t have a cap, which meant it failed to pool that risk.
Just how should we pay for it? Anyone I speak to seems to suggest that they wouldn’t mind paying a bit more in tax to sort it out. But how? Take money out of peoples’ estates after they die? Labour tried that, and it was quickly dubbed, by my side, as being a “death tax”. Maybe the Government could raise tax by means-testing pensioners benefits such as winter fuel allowances and ending the pension triple lock, but again whenever this has been floated there has been opposition to it, most recently by the DUP. Another idea floating around Parliament is turning national insurance into a ring-fenced health tax. Sarah Wollaston, the Conservative Chairwoman of the Health Select Committee believes national insurance should also be extended to those beyond retirement age who are presently exempt.
I have spoken to Jeremy Hunt many times about social care and the truth is he is not wedded to any one idea, he is “open to all options”, including a dedicated tax, because he knows more money must be found and fast. What is needed is courage and leadership to drive forward solutions, but integrating social and health care must be the right place to start.