Johnson urged to adopt bold approach to reform of social care

David Hughes and Jemma Crew, PA
·5-min read

Boris Johnson has a “now or never” opportunity to put in place a long-term plan to fund social care, former health secretary Jeremy Hunt said.

The Prime Minister could use the public support for the sector shown during the pandemic to set out why a new tax may be necessary to fund increasingly expensive care for an ageing population.

Mr Hunt suggested that addressing the issue – as Mr Johnson promised when he entered Downing Street – could provide the Prime Minister with a legacy similar to the establishment of the NHS in the aftermath of the Second World War.

Successive governments have failed to address a situation which can both leave families facing ruinously expensive care costs while the system as a whole struggles for funding.

Mr Johnson used his first speech as Prime Minister in July 2019 to say “we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve”.

But little progress has been made and the coronavirus pandemic has set back efforts to produce a new system.

The Commons Health and Social Care Committee, chaired by Mr Hunt, has called for £7 billion extra funding a year by 2023-24 to cover an increasingly ageing population and the rise in the National Living Wage affecting costs.

The MPs also recommended a £46,000 cap on the total costs anyone should have to pay for their care, drawing on recommendations made by economist Sir Andrew Dilnot as long ago as 2011.

Mr Hunt told the PA news agency: “I think the biggest battle now is with the Treasury, because the sums of money are eye-watering.”

But he added: “We were even more bankrupt as a country after the Second World War and then we had the imagination and vision to set up the NHS, and I think this is another 1948 moment.”

Mr Hunt suggested a tax on the middle-aged might be required to fund the system, along the lines of Germany and Japan.

“Both of them, interestingly, introduced a tax surcharge to people over 40, which is only a small amount extra, but as you get older you start to pay a little bit more. And neither have had public pushback for doing that,” he said.

The alternative was the model in countries like Italy or Spain, where families looked after their elderly relatives, something which often resulted in women staying at home rather than pursuing a career.

“I suspect that’s a price we would not want to pay in this country,” Mr Hunt said.

Prime Minister Boris Johnson
Prime Minister Boris Johnson (Stefan Rousseau/PA)

Mr Hunt, who ran against Mr Johnson for the Tory leadership and the keys to No 10, said the Prime Minister understood the need for action because “the way that we treat older people in this country has neither kindness nor decency at the moment”.

With the advantage of a healthy Commons majority and public support for action, Mr Hunt said the Prime Minister should adopt a bold approach.

“I just think the year after the pandemic, if we don’t do it now, it really is now or never. Because the public have never understood better how important our care system is.”

He added: “I don’t think Boris needs me to tell him this, but boldness always pays off in politics.

“And if you wanted to send the strongest possible signal that we are a one-nation Conservative Party that cares equally for young and old, then this is the strongest possible signal.”

Andy Burnham, a Labour former health secretary and now mayor of Greater Manchester, said people could now see how “broken” the care system is.

“I hope that people will demand reform of social care coming out of this,” he said.

“Another pandemic could hit any time and to let social care go into another pandemic in this state is immoral.”

The call for action was echoed by those working in the adult social care sector.

Vic Rayner, executive director at the National Care Forum, said 2021 “has to be the year that the Government once and for all takes hold of the importance and value of social care – and makes it front and centre of Government concern for all the right reasons”.

Simon Bottery, senior fellow at The King’s Fund health think tank, said Mr Johnson must act or he will become “yet another Prime Minister who promised reform but failed to deliver it”.

Jane Townson, chief executive of the UK Homecare Association, said no tangible progress has been made since the Prime Minister’s pledge on the issue.

She called for the Government to set out a clear vision for the sector and an approach which ensures people’s needs are met and costs covered “with fairness and clarity regarding the responsibilities of state and citizen”.

A Department of Health and Social Care spokesman said: “We are focused on ensuring all those who need it get the care and support to stay safe and well during the Covid-19 pandemic and throughout this winter, including through regular testing of staff and residents and free PPE.

“We remain committed to sustainable improvement of the adult social care system and will bring forward proposals as soon as possible.”