Baroness Campbell: Invest in working-age adults and it will pay for itself
This green paper must work for younger people in need of care and support, says Baroness Campbell
Given that the focus of public debate on social care is invariably about the “crisis of care for our ageing society”, it’s easy to overlook the fact that 50% of the social care budget supports people of working age.
The government seemingly ignored this, announcing – after a strong nudge from myself and others for parity of attention – that a ‘parallel process’ on working-age adults would run alongside the development of the green paper on funding social care for older people.
Matt Hancock, secretary of state for health and social care, has now declared that the green paper will, after all, encompass working-age adults. Is this a step in the right direction?
The question is relevant because, while including working-age adults indicates some degree of parity, the policy drivers and assumptions underpinning the green paper fail to speak to the younger generation. The circumstances of working-age disabled people in need of care and support are different; one generation is building a life, the other living retirement. Asking for parity of attention, they will not settle for parity of approach.
Search the words ‘social care’ on the internet and the stock image is of a wrinkly hand being held by a young one; social care is portrayed as managed decline, not human development. The funding debate lexicon is dominated by cost pressures, not investment and opportunity. Residential care is seen as a positive option, not the denial of human rights. Any discussion of integration tends to focus on social care supporting NHS ‘bedblocking’. It’s not seen as part of wraparound support for individuals to lead their own lives.
For many working-age disabled people, having access and control over adequate personalised support is about realising our right to be included in society. It is not what we’re given when we need help with eating or going to the bathroom. We’re looking for a life, not survival. Hence, the question: “What is it we are seeking to fund for a future social care system?” needs to be clearly stated, and addressed, in the green paper.
As for the funding question itself, the primary issue is the appropriate balance between state and private financial contributions. The debate is focused on how much of our accumulated wealth – especially housing assets – we are allowed to ‘protect’ from social care costs and pass on to our children and grandchildren when we die.
One could conclude that such a cap is inherently progressive since those with the fewest savings and assets will pay the least. Certainly, many working-age disabled people who now receive or may in future require care and support, but who haven’t had opportunities to save or build assets, will be least likely to face care costs.
But as I point out above, it is unclear what would count as publicly funded care and support. I fear this approach will result in continued tight eligibility criteria with continued, if slightly less, charging for social care. Thus ‘life and limb’ support will still be the bottom line when the economy takes a hit.
Many disabled people may be thankful for small mercies. But in a country which claims to be a world leader on disability rights, that’s not going to cut it. Supported survival, whether in hospital or the isolation of our own home, is not a life worth living.
In 2009, almost a decade ago, the UK ratified the UN convention on the rights of persons with disabilities, with cross-party support. It reaffirms our “right to live independently and to be included in the community”. That means doing what people without a disability do – socialising, raising a family, working, and all the other things that make up day-to-day living in society. The UN convention requires the UK government “to ensure that disabled people have access to a range of … services, to support living and inclusion in the community”.
Surely that is the test to judge any funding proposals. Invest in working-age adults and it will pay for itself.
Baroness Jane Campbell of Surbiton is a Crossbench peer