The architect of the government’s delayed reforms to social care has told Sky News politicians need to “grow up” and tackle the crisis in the sector.
Amid a bitter election row over public spending, Sir Andrew Dilnot said he believed the two main parties were reluctant to discuss care reform for fear of being accused of plotting future tax hikes.
Sir Andrew – whose 2011 report laid out several key measures adopted by the government – described social care as the “biggest risk that isn’t managed” that the country faces.
He said: “Four out of five people are going to need social care before they die, we should grow up and face it.
“I think politicians are reluctant to talk about it firstly because they’re worried about anything that means an increase in public spending and therefore possible taxation,” he said.
Sir Andrew Dilnot
The implementation of a cap on care costs, unveiled by Boris Johnson, was delayed in 2022 until October next year.
The policy promised to limit the amount anyone in England will spend on personal care over their life to £86,000.
Speaking to Sky News on the campaign trail, Rishi Sunak said those charging reforms were still “on track”.
Labour has not explicitly committed to the cap in its manifesto, but a party source confirmed that it would also bring in the reforms as planned.
While the Liberal Democrats have made social care a key part of its policy offering, the sector has barely featured in the campaigns of the main two parties.
The cost of unpaid care
Norman Phillips is a carer for his wife Ros – who lives with multiple sclerosis and dementia.
Initially he was able to combine work with his caring responsibilities but as Ros’s condition worsened, he took early retirement.
“It was the stress and strain of trying to work… and saying look I’m terribly sorry, but I’ve got to turn around and go back to Stevenage because I can’t find anyone to look after Ros… that was tolerated for a while because I always got the work done… but then it went a bit pear shaped and… I collapsed in the street,” he said.
The couple found help hard to come by and after Norman suffered an injury, they were forced to sell their home to settle care-related debts.
“My kids learned a long time ago that their inheritance is gone… we don’t have any money left. We didn’t have any money left a while back,” Mr Phillips said.
Ros is now subject to an NHS continuing healthcare plan after Norman suffered a breakdown earlier this year and authorities decided he was unable to carry on caring for his wife.
This includes round the clock care for Ros – something Norman says wouldn’t have been needed if a lower level of help had been made available earlier.
He said: “They’ve got six million of us unpaid carers. If they… help us, we can help the system.
“But what’s happened to me, you know, is the system just kept backing away and backing away until I cracked.”
The idea of a cap was first suggested by the Dilnot Commission and put into legislation in 2014.
However its planned implementation in 2016 was delayed by the David Cameron government on cost grounds.
An attempt to reform the sector during the 2017 election was widely seen as the reason for Theresa May losing her Commons majority.
In his first speech as prime minister in 2019, Boris Johnson said he had a “clear plan” to “fix the crisis in social care once and for all”.
Reforms were announced in 2021 alongside an increase in National Insurance to fund the wider sector.
However this tax rise was reversed under Liz Truss before the broader changes were delayed under Rishi Sunak.
It means that many people requiring care are still potentially liable for costs that can stretch to thousands of pounds per month.
Norman Phillips
Norman and Ros on their wedding day
Sir Andrew said the lack of suitable social care was also having a “knock on effect” on the NHS as older people ended up stuck in hospitals.
“Lots of elective procedures rely on being able to have a bed and if you’ve got one older person… in hospital for twenty days more than is needed, that could easily mean ten hip replacements not being able to happen because there isn’t the bed space,” he said.
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Norman and Ros
Care bosses have also highlighted staffing shortages caused by low pay as another key problem in the sector while councils have called for more funding from the government.
Speaking to Sky News, Rishi Sunak said £8.5bn was put into the NHS and social care shortly after he became prime minister and that his government had focused on “improving the link between social care and hospitals… but also investing in the workforce”.
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A Labour source said “the social care chapter in our manifesto includes a commitment over the next decade to build a national care service, and first steps of a fair pay agreement for care workers”.
Shadow health secretary Wes Streeting also admitted that he wanted a “more ambitious” social policy but that it had to be “affordable” to be included in the manifesto.