The coalition fails to rise to the challenge on social care

The £75,000 cap on costs planned by the government will help just 10 per cent of those needing care.

More than 18 months after Andrew Dilnot's landmark report into social care was published, the coalition will finally unveil its planned reforms today. In a statement to the Commons, Jeremy Hunt will announce that the government will introduce a cap of £75,000 on care costs and increase the threshold for means-tested support from £23,250 to £123,000, so that no one with assets worth less than this amount is forced to pay. The £1bn-a-year cost of the plan will be met through higher national insurance contributions on employers and a six-year freeze in the inheritance tax threshold at £325,000 (George Osborne's famous 2007 pledge to increase it to £1m now being a distant memory of a pre-austerity age). 

The first point to note about the £75,000 cap is that under the coalition's timetable it won't actually be introduced until April 2017. Thus, as shadow care minister Liz Kendall has noted, it "won't do anything for the hundreds of thousands of elderly and disabled people who are facing a desperate daily struggle to get the care and support they need right now".

In addition, the cap, which excludes food and accommodation costs (typically around £7,000-£10,000 a year), is set a significantly higher level than that recommended by Dilnot. His report called for a cap of between £25,000 and £50,000 (settling on a figure of £35,000) and warned that anything outside of this range "would not meet our criteria of fairness or sustainability". A cap above £50,000 "could mean people with lower incomes and lower wealth would not receive adequate protection." Even if we adjust the £75,000 cap for inflation (it is based on 2017 price levels), that still leaves it at £61,000 - £11,000 higher than Dilnot's recommended maximum.

Interviewed on the Today programme this morning, Dilnot said that he regretted the coalition's decision to opt for a £75,000 cap but recognised that "the public finances are in a pretty tricky state". By capping costs for the first time, the plan would still "radically reduce anxiety", he argued. But others have been less generous. 

Labour has pointed out that since it will take the average person around four years before they reach the cap, it will not benefit the majority of patients, most of whom don't make it this far. Dot Gibson, the general secretary of the National Pensioners Convention, estimates that the proposals will help "just 10 per cent of those needing care". Labour is currently developing its own social care plan as part of its policy review but is likely to recommend a cap no greater than £50,000. 

The government's hope is that a cap of £75,000 will encourage insurers to offer policies to cover costs below this amount. As Hunt said on The Andrew Marr Show yesterday, "We don't want anyone to pay anything at all. By setting an upper limit to how much people have to pay, then it makes it possible for insurance companies to offer policies for people to have options on their pensions so that anything you pay under the cap is covered."

But Labour is highlighting the fact that Nick Starling, the director of general insurance and health at the Association of British Insurers, has previously dismissed this as wishful thinking. He told the health select committee in November 2011: "I do not think there will be pre-funded products. That is unlikely. I speak on behalf of the insurance industry, but I bring independence in the sense that, except for the immediate needs annuities which [Chris] Mr Horlick [of Care Partnership Assurance] provides, there are no products out there. I am not grinding a particular axe about particular forms of products. I am saying that, in a sense, we have a chance to think in quite an open way, unencumbered by a whole forest of products already out there. In that sense, the thinking we have been doing on this is independent."

A cap on costs is, as Dilnot suggested, better than no cap at all. But unless Hunt springs a surprise on MPs today, it is already clear that this will not be a lasting solution to the care problem. For that, one suspects, we will have to wait for a change of government.  

Health Secretary Jeremy Hunt will announce the government's planned social care reforms today.

George Eaton is political editor of the New Statesman.

Photo: Getty Images
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Autumn Statement 2015: How should Labour respond?

The government always gets a boost out of big setpieces. But elections are won over months not days. 

Three days in the political calendar are utterly frustrating for Her Majesty’s Loyal Opposition – the Queen’s Speech, the Budget and the Autumn Statement. No matter how unpopular the government is – and however good you are as an opposition - this day is theirs. The government will dominate the headlines. And played well they will carry the preceding with pre-briefed good news too. You just have to accept that, but without giving in or giving up.

It is a cliche that politics is a marathon not a sprint, but like most cliches that observation is founded in truth. So, how best to respond on the days you can’t win? Go to the fundamentals. And do the thing that oddly is far too little done in responses to budgets or autumn statements – follow the money.

No choices in politics are perfect - they are always trade offs. The art is in balancing compromises not abolishing them. The politics and the values are expressed in the choices that you make in prioritising. This is particularly true in budgets where resources are allocated across geographies - between towns, cities and regions, across time - short term or long term, and across the generations - between young and old. To govern is to choose. And the choices reveal. They show the kind of country the government want to create - and that should be the starting point for the opposition. What kind of Britain will we be in five, ten, fifteen years as these decisions have their ultimate, cumulative impact?

Well we know, we are already living in the early days of it. The Conservative government is creating a country in which there are wealthy pensioners living in large homes they won, while young people who are burdened with debts cannot afford to buy a home. One in which health spending is protected - albeit to a level a third below that of France or Germany – while social care, in an ageing society, is becoming residualised. One where under-regulated private landlords have to fill the gap in the rented market caused by the destruction of the social housing sector.

But description, though, is not sufficient. It is only the foundation of a critique - one that will succeed only if it describes not only the Britain the Tories are building but also the better one that Labour would deliver. Not prosaically in the form of a Labour programme, but inspirationally as the Labour promise.

All criticism of the government – big and little – has to return to this foundational narrative. It should connect everything. And it is on this story that you can anchor an effective response to George Osborne. Whatever the sparklers on the day or the details in the accompanying budgetary documentation, the trajectory is set. The government know where they are going. So do informed commentators. A smart opposition should too. The only people in the dark are the voters. They feel a pinch point here, a cut there, an unease and unfairness everywhere – but they can’t sum it up in words. That is the job of the party that wants to form a government – describing in crisp, consistent and understandable terms what is happening.

There are two traps on the day. The first is narrowcasting - telling the story that pleases you and your closest supporters. In that one the buzzwords are "privatisation" and "austerity". It is the opposite of persuasion aimed, as it is, at insiders. The second is to be dazzled by the big announcements of the day. Labour has fallen down here badly recently. It was obvious on Budget Day that a rise in the minimum wage could not compensate for £12bn of tax credit cuts. The IFS and the Resolution Foundation knew that. So did any adult who could do arithmetic and understood the distributional impact of the National Minimum Wage. It could and should have been Labour that led the charge, but frontbenchers and backbenchers alike were transfixed by the apparent appropriation of the Living Wage. A spot of cynicism always comes in handy. In politics as in life, if something seems to be too good to be true then … it is too good to be true.

The devil may be in the detail, but the error is in the principle – that can be nailed on the day. Not defeated or discredited immediately, but the seeds planted.  

And, if in doubt, take the government at their word. There is no fiercer metric against which to measure the Tories than their own rhetoric. How can the party of working people cut the incomes of those who have done the right thing? How can the party who promised to protect the health service deliver a decade of the lowest ever increases in spending? How can the party of home ownership banish young people to renting? The power in holding a government to account is one wielded forensically and eloquently for it is in the gap between rhetoric and reality that ordinary people’s lives fall.

The key fact for an opposition is that it can afford to lose the day if it is able to win the argument. That is Labour’s task.