Health Matters | Paul Corrigan's blog

Yesterday I was at the Reform conference on paying for social care for the elderly and the chair, Patrick Nolan, Chief Economist for Reform cited today’s title as something I had said in my blog. So I feel justified to use it to describe today’s post.

One of the points I made about my generation – who are about to reach retirement age – is that whilst not all of the cohort is well off and there are considerable inequalities within the age group, it’s interesting to note that nearly all of us are better off than our parents were when they retired. Of course some of us own property, and some do not, which means that assets are not evenly distributed amongst us, but pensions reflect our higher earnings and both small and large assets have been accrued over time as a result of the higher wage rates available during our working lives that were not  there during our parent’s generation.

To reiterate – NOT that we are all well off; but that nearly everyone is better off than their parents were when they retired.

The next aspect of generational politics is that it is very likely that my generation will be better off at retirement than our children’s will be at theirs. Of course this is not a fact about which we can be certain but it does look likely.

Therefore if during our retirement social care is going to need more resources it seems wrong to take them in general taxation from the younger generation. That generation is having a tough enough time at the moment – and it may not get much easier.

So simply raising taxation from younger people may not be fair.

And there is of course an NHS dimension to this.

Anyone who works in the NHS recognises the important relationship between NHS and social care services. Since it is the case that 70% of beds in NHS hospitals are filled by retired people, the relationship between hospital care and social care is a vital one. If an older person lives on their own they may need care before they can go home and if they don’t get it in a timely way they stay in the expensive hospital bed for longer than they have to.

Therefore any problem with the funding of social care will reflect on the the funding of NHS care. Everyone at the conference discussed this relationship.

The big issue within social care funding has been the publication of the Dilnot Commission. This suggests different ways of getting more money into social care, and whilst no one would suggest it answers all the questions, getting some cross party political consensus around Dilnot is the really important game in town.

Andy Burnham made a speech outlining his belief that consensus could be developed and saying in particular that it was important to start implementing any new funding within the lifetime of this Parliament. You felt that the opposition wanted to take politics out of this issue. This seemed – as the title of this post suggests – to be the smart politics that this big policy issue needs.

There is a prospect of a White paper on social care in ‘the spring’ (This is an elastic civil service time period). This will be published by the Department of Health and the Secretary of State will lead on it.

Developing and selling a political consensus will be difficult for the political parties and it will also be necessary to sell any policy to the nation since there will be some winners and losers.

My fellow panellist Sarah Neville, Public Policy Editor for the FT, gently made the rather important point that the current Secretary of State’s skills in explaining the NHS reforms had been ‘sub optimal’. This drew an understanding laugh from the audience.

But the important point she was making is that it will need a Secretary of State for Health with very good communication and narrative skills to make the case for new social care funding to the nation – and perhaps that means the White Paper had better wait until there is a new Secretary of State.

I must say that given how badly the NHS reforms have gone – because there has been no compelling narrative – she has a point. Given the size of this policy change it is going to need someone smarter at politics than the current Secretary of State to bring it off.