The state system to care for older and disabled people is under acute pressure, and must be reformed

The absence of adequate social care is putting increased pressure on hospitals.

There is now an unprecedented consensus that the care system for older people and disabled adults in England is on the brink. It has gone far beyond the party political. Those who have spoken out include the health select committee, NHS leaders, local government leaders from all parties, independent health thinktanks and the regulator.

This diverse chorus of voices reflects the terrible human and financial cost of inadequate funding for care, revealed by Sonia Sodha today . The visible side of the crisis manifests itself in our hospitals. A lack of care funding means older people can’t be discharged when they are well enough to leave hospital, contributing to a dire shortage of hospital beds. It means older relatives end up in hospital with broken hips because they couldn’t get the help they need to wash and dress themselves.

The less visible side of the crisis is no less tragic. It is wreaking misery behind closed doors across the country. How must it feel to be an older person who struggles to eat and go to the toilet, living in virtual isolation with no support? Or to be struggling to combine working with taking responsibility for ensuring your elderly mother with dementia doesn’t hurt herself?

It also has a dreadful impact on those paid to provide state-funded care. How terrible must it be to work as a care assistant who has to choose between feeding or bathing someone who desperately needs help with both, on a 15-minute care visit?

How do you cope with the emotional stress of being asked to provide care, but never enough to support a decent quality of life, to whizz in and out to take care of someone’s physical needs with so little time it’s hard to show them some love?

How can anyone provide decent, human residential care on rates equivalent to £2 an hour, the rate some local authorities pay?

Enough is enough. The government’s continuing failure to heed the warnings are not just irresponsible but inhumane. It must take two steps.

First, and most urgent, when communities and local government secretary Sajid Javid sets out the local government finance settlement next week, he must make more funds available to councils to support people with their care. In particular, he must channel more money to the poorest areas of the country, which have the greatest levels of need.

Second, the government must once and for all come up with a long-term solution for funding care. Many of us will end up needing to use professional care services in later life. But who wants to imagine, plan and save for a future with dementia while they are in their 30s and 40s? This basic aspect of human psychology means the right way to fund our care services is the same way we fund our NHS.

The founding principle of the NHS was that healthcare should be available to all on the basis of need, free at the point of delivery. Seventy years later, that principle is as cherished as ever.

As long ago as 1999, the royal commission on long term care recommended this principle should be extended to personal and nursing care: free at the point of delivery, available to all on the basis of need. These recommendations were implemented by the Scottish government. Across the rest of the country, they were not, leaving the anomaly that someone suffering from cancer will have their care needs met by the NHS, whereas an older person suffering from dementia has to fund their own care unless they qualify for means-tested support.

The problem is not a want of a solution. It is a lack of political willpower. Yes, it will be expensive, but there are a myriad ways to pay in a country as rich as ours: through increasing income tax rates, through compulsory insurance payments for those aged over 40, as for instance in Japan, or through reversing this government’s cuts to inheritance tax.

The current path we are treading only ends in one place: a two-tier system where those who can afford to pay get the support they need; and those who cannot are condemned to suffer. We would not tolerate it in our hospitals, our GP surgeries and our schools; we must not tolerate it in our care services. The Observer urges the prime minister to act.

SOURCE: Observer Editorial, The Guardian