The old age elephant in the room
Does Andy Burnham seriously think that he can fix social care?
The ever-flickering outline of Andy Burnham’s premiership underwent another important shift last night when our man pledged to bring forward the Casey Review and tackle head-on the problem of social care.
No objection to this, in theory. The current condition of Dame Louise Casey’s review into social care is a joke. The Government appointed her to work out the feasibility of its ruinous promise of a National Care Service, and within a year the whole thing had been gelded by the Treasury:
The first stage of social care reforms will not be completed for a decade, according to a timetable imposed by the Treasury to delay costly changes.
A task force designed to build a cross-party consensus on fixing the crumbling elderly care system has been told its initial recommendations should be implemented by 2036, with “long-term” reform taking even longer.
Somebody really ought to have seen that coming. Social care is prohibitively expensive, and only getting more so as we get better at keeping people alive for longer and longer.
It also sits on a very nasty political dilemma. The easiest way to pay for social care under our current system would be to simply make people who could afford it pay for it themselves; yet not only would this be deeply unpopular but it also penalises people who save and try to pass something on to their children whilst the spendthrift have their tab picked up by the state.
Alternatively, one could try to step back from the impersonal and commercialised version of elderly care that we have currently ended up with. Historically, and to this day in many other parts of the world, the elderly are cared for by a (usually female) relative. But whilst that would make the whole business much more affordable, it would be terribly un-modern, and likely depend on a lot of what one progressive friend described as “unpaid female labour”. So that’s out too.
The irritating thing about Burnham’s posturing on this issue is that it’s always easy to posture when you’re not in power
Perhaps Burnham really does have the answer this time. It doesn’t seem very likely, though: back in 2009 his big idea was replacing inheritance tax with a “care levy”, an incredibly bad idea for several reasons. First, it involves playing around with IHT, one of the most universally disliked taxes in Britain (even by people who don’t pay it). Second, it creates perverse incentives even worse than Theresa May’s attempt did, because older people could either hoard their wealth to pay for their social care after they’re dead or, you know, spend the money and let the state pay. Which would you do?
The irritating thing about Burnham’s posturing on this issue is that it’s always easy to posture when you’re not in power — Sir Keir Starmer promised a national care service! The reason the whole issue got punted into the 2030s is because there is simply no room in the public accounts for a big, expensive undertaking such as fixing social care, and Labour MPs are utterly unwilling to make any of the sort of sacrifices which might create it.
Burnham has already pledged that he will stick to the Government’s fiscal rules. That means that any big new project — at least, any project which involves not capital investment but a significant and permanent increase in revenue expenditure, such as fixing social care — will need to be paid for either out of tax rises or spending cuts. Labour MPs won’t wear the latter, and the public’s patience with the former snapped some time ago. Besides which, the only tax hikes that could even possibly bring in revenue on the scale required would be the big taxes everyone pays — income tax, national insurance, etc. — and there’s again a good political reason that Rachel Reeves hasn’t tried that yet.
Once again, one wonders of Burnham (as one wondered of Boris Johnson) if he knows all this, if inside the bravado there is a cannier and surely now very worried man, imprisoned by the mantle of saviour of the Labour Party, fighting to seize responsibility for a basket of lethally poisonous policy problems because, like the scorpion stinging the frog, that it simply what men like him do.
Or perhaps he really does have so high an opinion of himself that he thinks the real problem with something like social care is that the intellect and character of Andy Burnham have not yet been applied to them. That was certainly the Johnson position. And he paid the price for it.
