Social care is back in the news, following a letter to the Daily Telegraph signed by 72 signatories including leading figures from charities, academia, peers and health representatives. The letter urges cross-party talks, and appears broadly to back the findings of the Dilnot Commission on social care, which recommended a cap on social care expenses for any individual, with the balance covered by the taxpayer, so as to prevent social care from eating all of an elderly person's resources late in life.
I have lots of objections to this. Let's start with the idea that if something is important, it should be done by cross-party consensus. Precisely the opposite is true. The things that are most important should be debated most vigorously, with alternatives presented and struggle between ideas. The concept that consensus is the way to solve important problems is one of the most odious, irritating and un-British memes of our modern age.
Skipping on, why is it supposed to be a problem, really, if elderly people with money end up spending it on their social care? I'm sorry that people get old and sick and die, but that's not something that's likely to change, and someone has to cover the costs. Why is it a problem if the person having the money spent on her is the one that pays? It's sad that when people get old they eventually have to part with their possessions, even their house. But why isn't that just part of getting old? There are perfectly good schemes in which people surrender ownership of their houses to a finance company, but continue to be entitled to dwell in the house until their death. So it isn't even as though we are necessarily talking of elderly people having to move. It's merely a matter of what they continue to own. Well – there is no "right to remain rich", surely?
Insofar as there is a genuine issue here, it is not that elderly people that have the money must spend it on their care. Surely the real issue is that some people do not have resources set aside to support them when old, and in particular that some are in that situation by choice – they chose not to save to pay for their social care. So it seems terribly unfair that elderly people that did save up find all their resources eaten up in social care, whilst others that did not save get paid for by the state.
Of course, that happens with lots of other things in life, such as pensions or unemployment or the education of children. But perhaps social care is an extreme example. If the real problem is those that do not save, we could respond to that in at least three ways:
- We could collectivise provision of social care, so that no-one pays for herself but, instead, everyone pays collectively. That way no-one evades paying.
- We could mandate that everyone makes provision for herself. For example, we could require everyone to have social care insurance.
- We could allocate the duty for funding social care to a morally responsible party other than (or in addition to) the infirm person herself.
In my view, the correct way forward here should involve some combination of options (2) and (3). We should steer clear of (1). Central nationalised provision of welfare is an idea whose time had come in the 1890s and gone by the 1950s. If we must use the state, then we should should be using it to enforce the duties that people have anyway. In the first instance, that means enforcing the duties people have to make provision for themselves – e.g. by insisting that, if they have the resources available, they take out social care insurance. In the second instance, that means enforcing the duties that family members have to each other. If your parents cannot pay for their own social care but you have money, then you should pay. If your sister cannot pay for herself, and you have enough money for you and her, then you should contribute to her care.
Your duties towards yourself and your duties towards your family come well ahead of your duties towards millions of people you have no blood connection to and have never met. A statement like that should, to a Conservative, be mundane and obvious. If socialists take a different view…well, that's why we have political debate and Parliamentary votes.