National Care Service | Good politics, bad policy

Party Conference season approaches, and Labour will be starting to flesh out the policies on which they will fight the next general election.

With the Conservative Party committed to a toxic mix of snobbery and Thatcherism there is lots of room for Labour to develop some really exciting ideas, aspirational, egalitarian, pro-business, anti-corruption. Their recent proposals on energy costs cut through with voters, particularly because the Government offered nothing in reply, and Starmer will be looking to capitalise

We already know what one of these is – the establishment of a National Care Service to put social care on the same footing as healthcare. Social care will be a a universally-available service, with personal care provided free at the point of use, and that all who need it can access it. Unlike the NHS however social care will remain mostly provided by the private sector.

This isn’t a new idea, it has been kicked around by Labour cor a decade, and is about to become law in Scotland. It is the kind of bold, decisive move that wins elections. Sadly it is also a really bad policy.

I have 2 enormous problems with it.

Firstly – it is fiscally regressive. It benefits the wealthy rather than the poorest. If I was an incoming Labour Prime Minister by over-riding priority would be redistribution – closing the gap between rich and poor by giving more to the poorest.

The poorest already get free social care through the means test – lifting the means test and making care free at the point of use benefits the rich over the poor, and my own family would benefit hugely from this. It is incredibly hard financially to achieve a redistribution of wealth and introduce the National Care Service – that is why the last 2 Labour manifestoes were fiscally regressive – they redistributed wealth to the already well off by policies such as lifting the means test on social care and scrapping tuition fees.

Given the shocking levels of poverty and hardship I don’t think I could vote for a policy that would make things worse.

My second problem is that it doesn’t tackle the supply side problem in social care. There is a slow motion staffing crisis unfolding in the social care sector. Low wages are endemic, and cutes of Local Authority funding make it hard to increase them. Brexit and the hostile environment has removed a large source of workers from abroad. The crisis in social care isn’t about how middle class families pay for it – it’s about how care providers supply a decent standard of care with not enough money or staff. Rising interest rate and soaring heating bills are pushing many care homes to the brink

Nor does the policy address the situation of carers, who too often live in poverty providing care for relatives.

Scotland has had free social care since 2002. At the time Scotland had the worst life expectancy in Western Europe, and i was shocked that the Scottish Government invested in free social care rather than tackling the causes of early death. 20 years of free social care has done nothing to improve the situation Scotland still has the worst life expectancy in Western Europe and Scots die nearly 2 years earlier than the rest of the UK.

So what would I do?

I would instead spend the money ending low pay across health and social care, making social care an attractive career again. I would commit to ending carer poverty within one Parliament. All of this would be lots cheaper than ending the means test.

I would also create a state care service by taking over care providers that hit financial problems and using them as a way for the state to be an active participant in the care market, particularly for residential care.

None of my concerns, however, are likely to cut through with voters. Although expensive, this is exactly the kind of middle class friendly reform to the welfare state that voters like. In contrast the Conservatives are intent on scrapping the increase in NI that was supposed to provide extra cash for the NHS and Social Care, without explaining whether this means more cuts to budgets. Boris’s firm commitment on the steps of Downing Street to produce a plan to fix social care vanished as he collapsed into endless scandal.

I was long sceptical about Starmers ability to get Labour over 36% in the polls – for a long time that looked like the upper limit of their support. I still don’t expect them to get over 40% at the next General Election, but with Labour comfortably in the high 30s Starmer has outperformed my expectations by a long way.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.