Dividing Lines: Getting old

The graph of doom.

In local government they call it “the graph of doom”. It is the chart with one steep downhill line showing budget resources and, soaring above it, another line showing the demand for services to look after an ageing population.

According to the latest census, one in six Britons is past retirement age. The number of pensioners will rise from roughly 12 million now to 16 million in 2050. The number of people aged over 100 (now around 12,000) will double over the next decade. As local authorities are responsible for adult social care, they won’t be doing anything else in the future unless the system changes.

What about the National Health Service?
It isn’t designed to provide long-term care for the elderly. Many people discover that only when they or their parents need urgent help. By some estimates, a third of all hospital beds are occupied by elderly patients. Long-term social care, arranged by councils, isn’t free for all. There’s a means test.

That’s the bit where I sell my house, right?
Under current rules, if you are worth more than £23,250 you pay. How much depends on the kind of care you need and where you live but the exposure is potentially unlimited. That often means cashing in equity.

Politicians should do something.
They are. The government is proposing a cap of £75,000 on the amount any one person would have to spend, starting in 2017. There will be a new, tapered means test starting at £123,000 – and so someone worth £50,000 still has to pay something, but less than someone worth £100,000. No one should pay a penny beyond the £75,000 cap.

Really?
No. In the small print, you are still liable for some “hotel costs” – the bed and board element of residential social care, the logic being that you’d still be paying for that sort of thing at home. But the state will now ease the burden for tens of thousands more pensioners.

If all these people are being let off the hook, where does the money come from?
The Treasury will need to find about £1bn extra per year. Some of this will be coming from additional employer National Insurance contributions. Most will be raised by freezing inheritance-tax thresholds, skimming more revenue over time from legacies of the dead.

Death taxes! Yuck!
Funny you should say that. It’s the very line that the Tories used in the 2010 general election campaign when attacking a Labour plan for universal social care, funded in part from inheritance taxes.

Oh, the irony.
That’s one word for it. That campaign poisoned relations between the Labour and Tory health teams, which made cross-party agreement impossible even though everyone agrees this is one of those big, long-term issues that demands collaboration. After the election, the coalition commissioned Andrew Dilnot, an eminent statistician, to come up with a plan. His report, published in July 2011, forms the basis of the coalition’s proposal. The government’s cap is a bit less generous than Dilnot recommended.

It took them 18 months to make that tweak?
It took them the best part of 18 months to summon up the courage to do much at all. There was a social care white paper last year that avoided the Dilnot route, which sounded a bit difficult and expensive to implement. Then the coalition parties realised that they needed some policy for the second half of the parliament. That became more urgent the clearer it got that fixing the national finances – formally declared Tough Issue Number One and the coalition’s stated raison d’être – wasn’t being tackled to anyone’s satisfaction. So Dilnot’s plan was fetched into Downing Street from the long grass.

And how’s that cross-party consensus coming along?
Labour has responded cautiously to the new coalition plan, with variations on the classic “too little, too late” holding rebuttal. Separately, Andy Burnham, the shadow health secretary, has devised a grand plan to integrate social care with the NHS. The idea, under the rubric of “whole-person care”, is to find ways to maximise the value that society gets from the huge health budget with a more strategic focus on promoting healthy, happy living – supporting the elderly to stay in their homes, for example. That, in theory, works better and costs less than the present inefficient process, which intervenes too late and ends up throwing money at random at the consequences of unhealthy lifestyles and poorly managed chronic conditions.

What does that mean in practice?
There’s a review to work out the details.

What about the money?
The right kind of interventions at the right time save money in the long term, as health and social care spending would go much further if the system wasn’t forced into making so many costly last-minute emergency interventions. Hospitals wouldn’t be turned into vast geriatric warehouses.

Long-term savings appear only in the long term. You’d need money upfront to fix social care, even just to match what the government is doing.
Yes, you would. And when Labour finally decides what its spending priorities are, there is a strong chance this will turn out to be one of them.

Rafael Behr is political columnist at the Guardian and former political editor of the New Statesman

This article first appeared in the 25 February 2013 issue of the New Statesman, The cheap food delusion

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I can’t follow Marie Kondo's advice – even an empty Wotsits packet “sparks joy” in me

I thought I’d give her loopy, OCD theories a go, but when I held up an empty Wotsits bag I was suffused with so many happy memories of the time we’d spent together that I couldn’t bear to throw it away.

I have been brooding lately on the Japanese tidying freak Marie Kondo. (I forgot her name so I typed “Japanese tidying freak” into Google, and it was a great help.) The “Japanese” bit is excusable in this context, and explains a bit, as I gather Japan is more on the case with the whole “being tidy” thing than Britain, but still.

Apart from telling us that we need to take an enormous amount of care, to the point where we perform origami when we fold our underpants, which is pretty much where she lost me, she advises us to throw away anything that does not, when you hold it, “spark joy”. Perhaps I have too much joy in my life. I thought I’d give her loopy, OCD theories a go, but when I held up an empty Wotsits bag I was suffused with so many happy memories of the time we’d spent together that I couldn’t bear to throw it away.

After a while I gave up on this because I was getting a bit too happy with all the memories, so then I thought to myself, about her: “This is someone who isn’t getting laid enough,” and then I decided that was a crude and ungallant thought, and besides, who am I to wag the finger? At least if she invites someone to her bedroom no one is going to run screaming from it, as they would if I invited anyone to my boudoir. (Etym: from the French “bouder”, to sulk. How very apt in my case.) Marie Kondo – should bizarre circumstance ever conspire to bring her to the threshold – would run screaming from the Hovel before she’d even alighted the stairs from the front door.

I contemplate my bedroom. As I write, the cleaning lady is in it. To say that I have to spend half an hour cleaning out empty Wotsits packets, and indeed wotnot, before I let her in there should give you some idea of how shameful it has got. And even then I have to pay her to do so.

A girlfriend who used to be referred to often in these pages, though I think the term should be a rather less flippant one than “girlfriend”, managed to get round my natural messiness problem by inventing a game called “keep or chuck”.

She even made up a theme song for it, to the tune from the old Spiderman TV show. She would show me some object, which was not really rubbish, but usually a book (it may not surprise you to learn that it is the piles of books that cause most of the clutter here), and say, “Keep or chuck?” in the manner of a high-speed game show host. At one point I vacillated and so she then pointed at herself and said, “Keep or chuck?” I got the message.

These days the chances of a woman getting into the bedroom are remote. For one thing, you can’t just walk down the street and whistle for one much as one would hail a cab, although my daughter is often baffled by my ability to attract females, and suspects I have some kind of “mind ray”. Well, if I ever did it’s on the blink now, and not only that – right now, I’m not even particularly bothered that it’s on the blink. Because, for another thing, I would frankly not care to inflict myself upon anyone else at the moment.

It was all a bit of a giggle eight years ago, when I was wheeled out of the family home and left to my own devices. Of course, when I say “a bit of a giggle”, I mean “terrifying and miserable”, but I had rather fewer miles on the clock than I do now, and a man can, I think, get away with a little bit more scampish behaviour, and entertain a few more illusions about the future and his own plausibility as a character, when he is squarely in his mid-forties than when he is approaching, at speed, his middle fifties.

Death has rather a lot to do with it, I suppose. I had not actually seen, or touched, a dead body until I saw, and touched, my own father’s a few weeks ago. That’s what turns an abstract into a concrete reality. You finally put that to one side and gird up your loins – and then bloody David Bowie snuffs it, and you find yourself watching the videos for “Blackstar” and “Lazarus” over and over again, and reach the inescapable conclusion that death is not only incredibly unpleasant, it is also remorseless and very much nearer than you think.

And would you, dear reader, want to be involved with anyone who kept thinking along those lines? I mean, even if he learned how to fold his undercrackers into an upright cylinder, like a napkin at a fancy restaurant, before putting them in his drawer? When he doesn’t even have a drawer?

Nicholas Lezard is a literary critic for the Guardian and also writes for the Independent. He writes the Down and Out in London column for the New Statesman.

This article first appeared in the 05 February 2015 issue of the New Statesman, Putin's war