Why aren't politicians talking about social care?

Patient and carer
[Getty Images]

At 59, Brian is living a very different life from the one he expected. He used to be an electrician making a good living. “Everyone needs an electrician,” he says.

But Brian can no longer work. He has a tremor that shakes his body uncontrollably, caused by a brain condition similar to Parkinson’s Disease. In his south Manchester flat, he sits surrounded by the model aeroplanes that he used to paint as a hobby but no longer can. His curtains are drawn to give him privacy from the road outside.

He needs help with the simplest tasks, such as feeding himself and dressing, but the care system he and many others rely on has been in crisis for years.

He says the shaking is exhausting. He also has epilepsy.

Perhaps like most people, Brian never expected he would need social care. But in a population that is ageing and living longer with complex conditions, many of us will.

Brian has to contribute £500 a month towards his own care bill [BBC]

About a million people in England receive services that support them in care homes as well in their own homes, according to the King’s Fund think-tank. Many who rely on the care system want to know why the major political parties aren’t talking about it more.

An open letter has been sent to politicians signed by 24,000 people and more than 50 organisations warning it would be a betrayal of the public if a new government ignored social care. A second letter from another 20 bodies, including council groups and care workers, urges politicians to use the remainder of the campaign to be ambitious about reform.

And the care system is among the issues most commonly raised by people contacting the BBC's Your Voice Your Vote - which lets you suggest stories for BBC News to look into.

Some older and disabled people are left having to pay hundreds of thousands of pounds towards their care.

Age UK estimates that a further 2.6 million people need support with day-to-day tasks like washing, dressing and medication, but aren’t able to get that help.

In short, the system is outdated, unfair and crying out for reform - and on that there is broad political agreement.

But the two main political parties have steered away from detailed plans. In the first televised leaders’ debate of the general election campaign, Rishi Sunak and Sir Keir Starmer spent a total of 36 seconds on the subject - neither challenging the other on what they said.

You can perhaps understand nerves among Labour and the Conservatives as in previous elections both parties have seen campaigns crashed by the issue of social care.

In 2010, Labour’s plans to pay for universal long-term care were dubbed a “death tax” by the Tories. Then, in turn, the Conservatives’ 2017 proposals for social care funding were branded a “dementia tax” by Labour.

Boris Johnson’s government did set a timetable for introducing an £86,000 cap or limit to an individual’s care costs over a lifetime. Originally due in 2023, its introduction in England was delayed until October next year.

Labour and Conservatives have said they would go ahead with this care cap, but experts say the money allocated is already being used to prop up the existing system.

Both manifestos say they will improve pay and conditions for care staff. Labour also pledges to set up a National Care Service within 10 years.

But there is little detail – particularly when it comes to how care will be funded.

Smaller parties have been more ambitious. The Liberal Democrats and the Green Party have both said they would make personal care free.

The care systems in the rest of the UK have seen some change. They are more generous, and in Scotland there is already free personal care.

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But delays in tackling the care system’s deep-rooted problems in England have consequences – both human and economic.

Brian, for instance, gets four care visits a day. Although the council pays for most of this, he still has to contribute £500 a month towards the total bill. He is on benefits and is now in debt.

“I'm behind on my gas and electric and other bills with paying so much for the care. It is stressful,” he says.

He’s not sleeping at night because of the stress. He believes it is making him more poorly and increasing his shaking, so he now needs more care.

But the council can’t provide it, and he couldn’t afford to pay more towards it anyway.

As things currently stand in England, anyone with savings and assets of more than £23,250 has to pay for all of their care. The value of their family home is counted if they move into a residential home.

People who fund themselves can end up paying between £1,000 and £2,000 a week for a care home place. Many of them are far from asset-rich. It can devour savings and lead to family homes being sold.

Imelda and Nicola dancing
[Nicola Hurst]

At a care home in the Wirall, 86-year-old Imelda dances around her room with her daughter Nicola Hurst.

In the background, Frank Sinatra croons “I’ve got you under my skin” as they sway to the familiar music.

Imelda has dementia and has lived in the home for about four years.

She is part of a large, close family and her daughter or one of her other relatives visit her most days.

Imelda had no savings and didn’t own her own home, so in theory her council pays for all her care.

But in reality, the amount provided by the council doesn’t cover the care home’s £1,200 weekly fees, so Nicola and her brother pay a £2,200 top-up each month to allow their mother to stay in the place she is familiar with.

“What keeps me awake at night is the thought that I now won't have enough in my savings pot to pay if I ever need to go into care,” says Nicola, who is retired. “And therefore, that financial burden will pass to my children.”

She is involved with the group Rights for Residents and campaigns for more recognition of the importance of families in social care.

“Successive governments accept that this is crisis,” she says. “They accept that this is something that has to be addressed. And yet, they do nothing.”

But in England, at least, money continues to be a stumbling block, according to Sally Warren, Director of Policy at the King’s Fund. She used to be a civil servant and helped draw up plans for the care cap.

“Political parties are really anxious about making any commitment to improve the system and having to find the money,” she says.

Last year £28bn was spent on social care in England and reform would cost several billion pounds more.

There has been some mention during the campaign of cross-party talks to agree a way of funding social care in the long term. Sally Warren sees that as a red herring that would slow things down.

“What you need is a government that’s prepared to take action, that will legislate when it is needed, and will follow through and implement,” she says.

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Whoever wins the general election there will be tough choices about money and the danger is that once again social care is placed on the “too-difficult-to-handle” pile.

But continuing to do nothing is also expensive, leaving the under-pressure NHS and families picking up the pieces.

And so when it comes to the election, Brian has little time for politicians.

“I don’t think they support us, I don’t think they care,” he says. I ask him if he feels angry about this.

“Yeah’, he replies, then quickly tells me he’s getting agitated. “They don’t treat us right.”

Nicola Hurst is even blunter. She wants politicians to “do their job”.

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