Dame Sally Powell's Campaign For Free Home Care, In Memory Of Iain Coleman

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As a council leader, the late Labour MP Iain Coleman made his London borough the only place in England where care at home is free. Then he needed it. Ben Gartside speaks to his widow, Dame Sally Powell, about her campaign to secure reform

Even at the time the move was radical: free home care, including personal care, without means-testing for any eligible resident. “We just did it because we knew it was the right thing to do,” Dame Sally Powell says of the decision she and others, including her late husband Iain Coleman, took in Hammersmith and Fulham in 1991.

Years later, the home care service became free again after Labour retook control of the west London council in 2014 – and it remains radical and indeed unique in England. The free service covers care in the home: washing, dressing, meals, medication, getting in and out of bed, for anyone the council assesses as having eligible needs.

Today, in her husband’s memory, Dame Sally is starting a national campaign that asks for care at home, free at the point of need, to be available everywhere. Although she says the policy choice was made in 1991 because it was “the right thing to do”, there was a bitter irony – some 13 years after its introduction, Coleman became one of the borough’s residents to be eligible.

Throughout the 1990s, they were a formidable power couple – two-thirds of an effective triumvirate. “Iain was in charge of the unions, Andy Slaughter was in charge of the money, I was in charge of the land,” Dame Sally says.

Coleman was elected MP in 1997 but one evening in 2004 he collapsed while shopping in M&S.

“In those days we didn’t have the knowledge about what a stroke looked like,” Dame Sally says. By the time she got him to Charing Cross hospital he had had eight strokes in a day; he came out paralysed down his left side.

He was only 46. Shortly before the 2005 general election, Coleman was advised to stand down, as he would be eligible for his pension on medical grounds.

At that point, Coleman and Dame Sally found themselves in the position of service users rather than political leaders, and discovered the grim reality of the system around care in the UK.

Coleman initially spent some time in the extra care shelter, but it didn’t click.

“Iain hated it. He just wanted to watch the Arsenal... He was very unhappy there. He had mice, and we had to get a cat for him. It was called Dennis Bergkamp, funnily enough. And so then I bought him a shared equity flat underneath me.”

Speaking today, Dame Sally describes the system as like a “jigsaw”. “For three years, we did not get Disability Living Allowance, because I didn’t know,” she says. “No one told me. My doctor, the hospital. No one told me.”

Nor did anyone tell her about the council tax. A severe stroke can leave someone classed as severely mentally impaired for council tax purposes, which means they are disregarded altogether – a status a GP must certify, and one that carries no statutory time limit on backdating.

“I didn’t know until he died,” Dame Sally says. “Iain was entitled, because of his stroke, not to pay council tax. But he’d been paying council tax for 14 years, and I didn’t know that one, but I do now. So, I’m making a claim against the council for a refund.”

The family did not apply for continuing healthcare, which would have moved the cost from the council onto the NHS. Dame Sally acted as a carer while not knowing of the existence of either Attendance Allowance, for those who need supervision from carers, or Carer’s Allowance, for those who spend much of their time caring for someone with a disability.

What did work was a question asked in a committee room. Dame Sally was sitting on the council’s social services scrutiny committee, in a meeting about adult social care, and asked the director about her own household. Why did her husband not get any? “I said, ‘You know him. He’s had a stroke.’ And from that day onwards, he had free adult social care.”

In 2020, she was struggling. Coleman had just been discharged from hospital into the pandemic, and she had no idea what to do. Despairing, she gave an interview to LBC to vent at the nightmarish situation she found herself in.

“But what about the hundreds of people who can’t, who don’t have the access that I fortunately could access? That’s what worries me”

Luckily for her, Sir Sadiq Khan heard it. By her account the London mayor rang the council that afternoon and told them to sort out Coleman’s care.

“Sadiq Khan was brilliant,” she says. “Even though he’s a Liverpool fan.”

Today, Dame Sally reflects on the benefits she had by living in the borough and knowing how the system works – and fears for the millions who have neither advantage.

“Iain was an MP. I was a councillor. I can do that,” she says. “But what about the hundreds of people who can’t, who don’t have the access that I fortunately could access? That’s what worries me. How many people are out there?”

“There must be so many people out there who just need this,” Dame Sally says.

Last September, Coleman died of pneumonia at the age of 67. By his wife’s count, he had 20 strokes over the last two decades.

At Coleman’s memorial service in Hammersmith, veteran Labour MP John McDonnell suggested launching a campaign in Iain’s memory in support of free home care. “It just took off from there,” Dame Sally says, “because I want everyone to have the care that Iain had.”

Iain and Sally with their son Jack in 1997

Using Coleman’s pension, Dame Sally is launching the campaign at Labour conference, alongside Stephen Burke, who was Hammersmith and Fulham’s cabinet member for social services in the years the policy was built and went on to lead the council.

While the future of care across the country is up in the air with the Casey Review, Dame Sally is pushing for Prime Minister Andy Burnham to begin pilots immediately.

“Get some local authorities to set up pilots, because you can’t be prescriptive – every area is different,” she says. She accepts the politics of it: “I know that he has to wait until Casey. I understand that politically.”

Dame Sally has faith in both Burnham and Yvette Cooper, his Health and Social Care Secretary, to find a solution.

“I have a lot of faith in Yvette Cooper. I know there’s the big three, but I think she’s got the most important job. It’s the one with the most challenges. She was a health minister a long time ago...She steered through that bill about stem cell research years ago. She was brilliant. And obviously she knew Iain, and I think she’s exactly the right person to make huge progress on this.”

In Burnham, she sees another politician having to confront the reality of the system; the Prime Minister’s father was living in a care home with Alzheimer’s until his very recent death.
Ultimately, Dame Sally wants to make life as comfortable for others as she managed for Coleman.

Towards the end of his life, he had palliative care in his own flat, round the clock. “He was as happy as a sandboy,” Dame Sally says, “because he didn’t have to go to Parliament, and he could watch Only Fools and Horses and the Arsenal. What else do you want in life?

“It can happen to any of us. It happened to me in Marks & Spencer’s one day.”