Social care for the elderly will be the first to go in the council cuts

What could replace it? "Adopt-a-granny" schemes, or a National Care Service, maybe.

Recent weeks have seen social security cuts ignite passions and viscerally polarise politics. Benefits reform lit the touch paper for disputes on the future affordability of the welfare state. But pensioner benefits, over half of the total welfare spend, are curiously off the table for discussion.

Yet if anything it is elderly care, rather than jobseekers payments, which will bankrupt the public finances. Constructive debate on the future of adult social services is more urgent than political wrangling on strivers vs. scroungers. Without it we risk sleep walking into a care crisis. 

The looming crisis hasn’t gone unnoticed by government over the past decade, yet no minister has yet arrived at a conclusive response. The latest attempt to grasp the nettle was made in Budget 2013, when the Chancellor agreed to fast track reform to social care funding. The government’s proposals are designed to make the system fairer, by protecting housing assets, but don’t tackle current spending pressure. 

Simply put, through capping individual payments at £72,000 from 2016, the government is addressing the balance of payments between the state and individuals. But the totality of funding will not change.

In response, a prominent Lords Select Committee has declared that the country is still “woefully underprepared for ageing.” Radical changes to the way that health and social care is delivered are needed to provide appropriate care and to address future demand.

Over the next two decades, England will see a 51 per cent rise in those aged 65+ and a doubling of those aged 85+. Many elderly people will be increasingly dependent on the care system. The Local Government Association estimates that this will see an increase in the care bill of £7bn - or about 15 per cent - over the decade. Worryingly, this is a "modest" estimate.

At the same time, until the social care system is reformed, money will continually be sucked out of other local services, such as roads, street cleaning and education support. This reality became apparent during research for NLGN’s latest report Gaming the Cuts, which is launched today. 

To inform the research we conducted a "budget war game" with senior council officers thinking through the implications of the cuts on an imaginary council called AnyBorough. Both teams quickly latched onto integrating health and social care, thinking that substantial savings could be made.

Back in the real world, many local authorities are already looking to bring clinical and public health commissioning together. Essex County Council is pioneering a new joint approach to tackle the £1bn elderly budget it shares with the NHS.

It is estimated that Essex’s new approach could save the public purse £348m by 2017/18. A study commissioned by the Local Government Association suggests that if such approaches were scaled up there could be a 5-year net benefit to the public sector of £5.8-£12bn. 

However, the budget war game made clear that savings from new models would likely flow to the acute sector. As a result, councils may look to the community to provide more social support. 

In England and Wales the informal care economy already accounts for approximately 3.4m working days every week, this is a substantial increase from 10 years ago. During our research it was therefore mooted that the public may have to be paid to deliver social services.

Currently, advocates for increased community involvement in adult social care point to the success of time dollar banking approaches first developed in Japan. Elderly people are befriended in order to combat loneliness and people account for the time spent in such schemes as a currency. They can then trade time to ensure that their own elderly relatives, who often live too far away to visit regularly, are supported.

But what if such Adopt-a-Granny schemes were based on a monetary transaction? Could support for elderly independent living be based on a similar financial footing to the fostering of children, with allowances paid to accredited carers?

Although seemingly radical the principle behind such an approach makes sense. For many people social relations are as important to physical and mental health as social services.

Yet, considerable risk would be transferred onto the community and more money saved would only be a drop in the ocean of the health and adult social care bill. But most importantly, monetisation could have unforeseen consequences on the sense of community and mutual relations that is at the heart of caring. 

With health integration and community care likely to be insufficient we are left with a seemingly intractable situation. Councils are even beginning to raise the possibility of social care spend being taken away from them, through a National Care Service for example, so that they can focus on making investments for local prosperity and growth. Just two years ago this would have been unthinkable, but such is the pressure now facing councils that such heresies are increasingly to be heard whispered around local government.

Photograph: Getty Images

Joe is a senior researcher at the New Local Government Network

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Emmanuel Macron: a populist eruption from the liberal centre

The French presidential candidate has been compared with a young Tony Blair.

The French presidential candidate Emmanuel Macron came to town this week to meet Theresa May and address the London French community, whose votes he was chasing. In our age of extremes, Macron, who is 39, is that rare thing – a populist eruption from the liberal centre. A former merchant banker and economy minister in the failing Hollande Socialiste administration, he represents En Marche! (“Forward!”), which is less a party than a movement. His sudden rise would not have been possible in Britain, which is part of the stability and attraction of the parliamentary system but also its frustration.

Don’t be shy

I met Macron on Tuesday afternoon when he took questions from a small group of journalists at Central Hall Westminster. He is small and dapper, with short hair and a strong, straight nose. Because of the collapse of the Socialistes and the struggles of the discredited conservative contender François Fillon, Macron has emerged as the great hope of liberals and perhaps as the candidate to stop Marine Le Pen seizing the presidency. Unlike the Front National leader, Macron is an unashamed liberal globaliser in the model of Nick Clegg or a younger, less tormented Tony Blair. He is a passionate advocate of the EU and of the eurozone and, as a result, is under attack from the Russian media. He has been accused of leading a double life – his wife, whom he met when she was his schoolteacher, is 20 years older than Macron – and of being unwilling to admit that he is gay, or at least bisexual. His response to the Russian attacks was, he said, “to disclose the manipulation and kill the rumours”.

The far right in France has caricatured Macron as being “globalisation personified”, about which he is relaxed. In conversation, he criticised David Cameron’s referendum campaign. “His message was ‘Yes but . . .’ That is not the answer to ‘No’. I defend Europe and the four freedoms of the EU. If you are shy, you are dead.”

Not all relative

On Sunday, I received a text from one of my cousins. “The Lincoln City manager and his brother, the assistant, are called Cowley,” he wrote. “His father looks a bit like your father. Any relation? They are from Essex.” I am also from Essex, born and brought up in Harlow new town, which turned 70 this year. But I had to disappoint my cousin. My father was an only child, as was his father, so it’s highly unlikely that these Cowley brothers are even distant relations of mine.

Toast of the county

I already knew about the brothers, having been alerted to them by my seven-year-old son, who is a sports data enthusiast. Last season, Danny Cowley and his younger brother, Nicky, were working as teachers in Essex while coaching Braintree Town at weekends. This season, they have led Lincoln to an FA Cup quarter-final against Arsenal, making them the first non-League team to reach the last eight in more than a century. Lincoln are also at the top of the National League (English football’s semi-professional fifth division) and in the quarter-final of the FA Trophy, the premier non-League cup competition. The Cowleys are reported to be subsisting on a diet of toast and Marmite as they rise early each morning obsessively to study videos and analytics and prepare for the next match. They have introduced a new spirit of openness at the previously moribund club: fans watch training sessions and attend press conferences.

It’s nonsense to believe, as some do, that only those who have performed at the highest level have the authority to coach the best. Wenger, Mourinho, Sven-Göran Eriksson, Roy Hodgson, André Villas-Boas: none of them were even remotely successful players. Asked once to explain his accomplishments, Mourinho said: “I’ve had more time to study.” More English coaches – so few of whom are working in the Premier League – would do well to follow his example.

It will be fascinating to see how far the Cowley brothers progress in the game. Whatever happens next, they have reanimated interest in the FA Cup and given the resilient yeomen of Essex a small boost.

Ignore the huckster

Boris Johnson accused Tony Blair of “bare-faced effrontery” for having the temerity last week to deliver an anti-Brexit speech, which itself was an act of bare-faced effrontery. Johnson is a huckster and narcissist whose vanities have been grotesquely indulged for far too long by his cheerleaders and paymasters in the media. (A standard question to Johnson when he was mayor of London: “You do want to be prime minister, don’t you?”) No one should take anything Johnson says remotely seriously. Should the same be said of Blair?

Yes, of course he is the author of his own misfortunes and many will never forgive the former Labour prime minister for the Iraq catastrophe. Yet of all the politicians I have spoken to in recent times, Blair was the most intellectually nimble and the most alert to the defining complexities of the present moment. As he demonstrated in his speech, he also understands better than most why, in an age of intensifying ethnic nationalism, the parties of the left are failing across Europe, none more so than the British Labour Party, which looks as far away from power as it did after the 1931 election.

Journey to the centre

As an energetic and charismatic liberal, Macron has been likened to the young Tony Blair. Can he seize the progressive centre, as Blair did, and destabilise the old binary divisions of left and right? “The anti-European and anti-globalisation extremes are winning elections,” he said, in a veiled reference to Donald Trump and the vote for Brexit. “But we don’t have the same political cycles as the others. It’s time for France to do the opposite.” With that said, he thanked his interlocutors and was hurried off for a meeting with another Essex man, Philip Hammond, pursued not by a bear but by the journalist Robert Peston. 

Jason Cowley is editor of the New Statesman. He has been the editor of Granta, a senior editor at the Observer and a staff writer at the Times.

This article first appeared in the 24 February 2017 issue of the New Statesman, The world after Brexit