Nick de Bois was the Conservative Member of Parliament for Enfield North 2010-15 and broadcast host with TalkTV.
I can think of no more a critical issue for the country than the future for social care. A cross-party resolution could be reached.
Yet both Conservative and Labour are so gripped by fear of the issue that they won’t even set out their own plans in the run up to a general election. They have both neglected the issue when in government despite the obvious foreseeable challenge of an ageing demographic and increase in dementia amongst our older population.
The fear that has gripped both political parties stems from the backlash to their attempts to offer the electorate solutions: first by Gordon Brown in Labour’s 2010 manifesto, which was branded the “death tax” by the Tories; then by Theresa May in 2017 ( swiftly dubbed the “dementia tax” by Labour).
They could learn from that experience and seek common ground by working together. Instead, the only common ground seems to be to kick the problem into more long grass.
Is it any wonder health and social care professionals and their representative organisations are frustrated with no sight of a concrete plan for ensuring elderly people – hundreds of thousands of them – who rely on social care, get the care and support they need?
Especially as those numbers are getting worse with 70 per cent of residents in care homes estimated to be suffering dementia or severe memory problems. Already, one in eleven people over the age of 65 have dementia in the UK. It is estimated that by 2030, there will be more than one million; in 2023 the University of London produced research concluding that 1.7 million people will be suffering from dementia by 2040.
Without a concrete plan for social care a failing system will become a broken one.
Of course, not everyone in need of social care has dementia. But they are in need of help to get by on a daily basis, and not all can turn to or rely on family.
The impact of this in hospitals was all too evident to me after a recent stay of twelve days on three different wards, where in two of them I was neighbour to very elderly men, lying on beds shorn of dignity, many in nappies, unable to feed themselves and bereft of any social interaction whatsoever.
That is shocking enough. But the impact on our NHS is debilitating. A Guardian analysis of official data in 2022 shows that on average 13,600 beds across NHS England are occupied every day with patients who doctors say are medically fit to go home or to a care home, equivalent to one in seven beds in acute hospitals.
As Wes Streeting rightly noted in his last party conference speech, there is “no solution to the crisis in the NHS that doesn’t include a plan for social care”.
However, he then went on to join a long list of politicians chanting the same mantra by merely repeating promises to create a National Care Service, which would guarantee better pay and conditions for carers, and aim to address recruitment and retention problems. Important, yes – but not enough.
The continued silence on these urgent but politically toxic questions – how to pay for the social care we need in society, improve both the quality and availability of that social care, and how to share the costs between family and taxpayer – is unacceptable.
To understand this it is perhaps first necessary to understand that in politics to get action governments must be confronted with a visible crisis constantly under media scrutiny which touches the lives or conscience of most people in this country.
The Post Office scandal hit the conscience of almost everyone, and the Government acted… Covid affected everyone in the country, and the government acted..
Social care doesn’t have that reach, though it should: it directly affects hundreds of thousands, and millions indirectly through the impact on the NHS.
Politicians of all colours know they are failing not just elderly people, but their extended families too. The cost of that failure is not just financial but, for those affected, emotional and physical too.
Many people are at risk of harm as they wait months, in some cases over a year, to receive a clinical diagnosis, despite their condition being blindingly and painfully obvious to relatives, because memory clinics are failing to meet the demand for assessment and preparation of care plans.
Without that, access to social care support is entirely in the hands of family members, who areoften left struggling to work out what is best for their loved ones without a coherent national support system. As Alzheimer Society noted in their 2021 report Hospitals and Care Homes:
“In care homes, some people with dementia have a diagnosis and while others do not. This means that many people are unable to access effective care and support that would allow them to live well with dementia.”
Imagine the absurdity of witnessing the cognitive decline of your parent, the risk they expose to themselves with simple daily tasks such as leaving the gas rings on or the front door open… and then discovering that if you can afford to house them in a care home (are lucky enough to find one that will take them) both you and it are technically at risk of breaking the law!
Why? Because if that dementia resident demanded to leave the building – with the danger that entailed – the care home should legally permit them to do so, because it has no right to require them to stay without a formal diagnosis and a Denial of Liberty Statement agreed. (This last is yet another cumbersome bureaucratic process that councils struggle to stay on top of.)
All this in the context of falling supply, not just in skills and labour but care homes themselves: in 2022, 162 care homes closed in England, and 2023 will most probably be worse.
Combined with rising demand, this shrinking of the sector is putting more financial pressure on users, many of whom (37 per cent, or 137,480 in the year March ’22 to February ’23) are self-funding care. In the Home Counties, prices now run to anything between £1100 and £2000 a week.
This problem is only going to get worse. The Conservatives know it, Labour know it. But unless they can tacitly agree to stop denouncing each other’s efforts as death and dementia taxes, nothing will get done.
Nick de Bois was the Conservative Member of Parliament for Enfield North 2010-15 and broadcast host with TalkTV.
I can think of no more a critical issue for the country than the future for social care. A cross-party resolution could be reached.
Yet both Conservative and Labour are so gripped by fear of the issue that they won’t even set out their own plans in the run up to a general election. They have both neglected the issue when in government despite the obvious foreseeable challenge of an ageing demographic and increase in dementia amongst our older population.
The fear that has gripped both political parties stems from the backlash to their attempts to offer the electorate solutions: first by Gordon Brown in Labour’s 2010 manifesto, which was branded the “death tax” by the Tories; then by Theresa May in 2017 ( swiftly dubbed the “dementia tax” by Labour).
They could learn from that experience and seek common ground by working together. Instead, the only common ground seems to be to kick the problem into more long grass.
Is it any wonder health and social care professionals and their representative organisations are frustrated with no sight of a concrete plan for ensuring elderly people – hundreds of thousands of them – who rely on social care, get the care and support they need?
Especially as those numbers are getting worse with 70 per cent of residents in care homes estimated to be suffering dementia or severe memory problems. Already, one in eleven people over the age of 65 have dementia in the UK. It is estimated that by 2030, there will be more than one million; in 2023 the University of London produced research concluding that 1.7 million people will be suffering from dementia by 2040.
Without a concrete plan for social care a failing system will become a broken one.
Of course, not everyone in need of social care has dementia. But they are in need of help to get by on a daily basis, and not all can turn to or rely on family.
The impact of this in hospitals was all too evident to me after a recent stay of twelve days on three different wards, where in two of them I was neighbour to very elderly men, lying on beds shorn of dignity, many in nappies, unable to feed themselves and bereft of any social interaction whatsoever.
That is shocking enough. But the impact on our NHS is debilitating. A Guardian analysis of official data in 2022 shows that on average 13,600 beds across NHS England are occupied every day with patients who doctors say are medically fit to go home or to a care home, equivalent to one in seven beds in acute hospitals.
As Wes Streeting rightly noted in his last party conference speech, there is “no solution to the crisis in the NHS that doesn’t include a plan for social care”.
However, he then went on to join a long list of politicians chanting the same mantra by merely repeating promises to create a National Care Service, which would guarantee better pay and conditions for carers, and aim to address recruitment and retention problems. Important, yes – but not enough.
The continued silence on these urgent but politically toxic questions – how to pay for the social care we need in society, improve both the quality and availability of that social care, and how to share the costs between family and taxpayer – is unacceptable.
To understand this it is perhaps first necessary to understand that in politics to get action governments must be confronted with a visible crisis constantly under media scrutiny which touches the lives or conscience of most people in this country.
The Post Office scandal hit the conscience of almost everyone, and the Government acted… Covid affected everyone in the country, and the government acted..
Social care doesn’t have that reach, though it should: it directly affects hundreds of thousands, and millions indirectly through the impact on the NHS.
Politicians of all colours know they are failing not just elderly people, but their extended families too. The cost of that failure is not just financial but, for those affected, emotional and physical too.
Many people are at risk of harm as they wait months, in some cases over a year, to receive a clinical diagnosis, despite their condition being blindingly and painfully obvious to relatives, because memory clinics are failing to meet the demand for assessment and preparation of care plans.
Without that, access to social care support is entirely in the hands of family members, who areoften left struggling to work out what is best for their loved ones without a coherent national support system. As Alzheimer Society noted in their 2021 report Hospitals and Care Homes:
“In care homes, some people with dementia have a diagnosis and while others do not. This means that many people are unable to access effective care and support that would allow them to live well with dementia.”
Imagine the absurdity of witnessing the cognitive decline of your parent, the risk they expose to themselves with simple daily tasks such as leaving the gas rings on or the front door open… and then discovering that if you can afford to house them in a care home (are lucky enough to find one that will take them) both you and it are technically at risk of breaking the law!
Why? Because if that dementia resident demanded to leave the building – with the danger that entailed – the care home should legally permit them to do so, because it has no right to require them to stay without a formal diagnosis and a Denial of Liberty Statement agreed. (This last is yet another cumbersome bureaucratic process that councils struggle to stay on top of.)
All this in the context of falling supply, not just in skills and labour but care homes themselves: in 2022, 162 care homes closed in England, and 2023 will most probably be worse.
Combined with rising demand, this shrinking of the sector is putting more financial pressure on users, many of whom (37 per cent, or 137,480 in the year March ’22 to February ’23) are self-funding care. In the Home Counties, prices now run to anything between £1100 and £2000 a week.
This problem is only going to get worse. The Conservatives know it, Labour know it. But unless they can tacitly agree to stop denouncing each other’s efforts as death and dementia taxes, nothing will get done.