Andy Burnham addresses the Labour conference in Manchester in 2012. Photograph: Getty Images.
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Social care reform will be a big vote winner for Labour

Burnham’s plan shows the party grappling with the kind of real world problems it would face in office. 

Labour’s big challenge ahead of its National Policy Forum meeting next month is to distil four years’ of abstract theorising, and often worthy but complex ideas, into a clear quality of life prospectus, the so-called "retail offer" for voters.

A classic example is access to childcare. This is a nightmarish issue for millions of parents, fusing together worries over affordability and quality of provision for a service that now counts as a cornerstone of a modern welfare state. But at the other end of the age spectrum – and equally worthy of being counted as a retail issue for voters – is the cost, quality and accessibility of social care for adults.

The public is already convinced it’s an issue. According to a 2012 poll by Carers UK, nearly half of adults in England (46 per cent) knew someone in their family who needed care and support with basic everyday tasks like eating, washing and dressing. In addition, 89 per of voters didn’t think it was fair that older and disabled people paid for the costs of their care.

Yet a recent report by the King’s Fund, led by economist Kate Barker, found that patients with different conditions like cancer and dementia ending up "making very different contributions to the cost" because the free entitlements of NHS care clash with the means-testing of the social care system. In a telling phrase, she found that the mismatched relationship between the NHS and local authorities, who are responsible for social care, means that the current systems "rub up against each other like bones in a fracture." She recommended a single, ring-fenced health and social care budget, ending the current salami-slicing of care provision.

And sliced it is. Age UK’s recent Care in Crisis report found that since 2010, spending on social care has dropped by £1.2bn (or 15.4 per cent). This squeeze on the finances of the social care system leaves "hundreds of thousands" of older people who have "moderate" needs, like help with getting dressed, without any assistance from their local council. The charity reckons that nearly nine out of ten local authorities have now limited their threshold for supporting elderly adults to those with "substantial" needs.

The current system is a complete mess, resulting in a postcode lottery of provision, with all the associated worry this causes. The belief is that integration will iron-out differential performance and entitlements in the care sector and help to reduce costs, with a recent survey by accountants PWC finding that 85 per cent of council leaders and chief executives agreed that integration would improve care outcomes.

This is shadow health secretary Andy Burnham’s big idea. He has long championed greater integration, indeed, one of the high points of the 2010 Labour leadership campaign, (amid the bromides and false bonhomie) was Burnham putting this idea into the mix. Although largely a technical change, Burnham’s plan speaks to voters’ fears about the standards of care their elderly relatives will receive - and whether or not their savings will be spent paying for it - classic retail politics territory.

But Burnham’s plan is also important because it shows Labour grappling with the kind of real world problems it will have to face up to if the party wins next year’s general election. Governing effectively after 2015 depends on being clear about priorities, being willing to innovate in the way services are provided and make less money stretch further. And nowhere is this more pressing than in dealing with the future of social care.

Kevin Meagher is associate editor of Labour Uncut and a former special adviser at the Northern Ireland office. 

Photo: Getty
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Like it or hate it, it doesn't matter: Brexit is happening, and we've got to make a success of it

It's time to stop complaining and start campaigning, says Stella Creasy.

A shortage of Marmite, arguments over exporting jam and angry Belgians. And that’s just this month.  As the Canadian trade deal stalls, and the government decides which cottage industry its will pick next as saviour for the nation, the British people are still no clearer getting an answer to what Brexit actually means. And they are also no clearer as to how they can have a say in how that question is answered.

To date there have been three stages to Brexit. The first was ideological: an ever-rising euroscepticism, rooted in a feeling that the costs the compromises working with others require were not comparable to the benefits. It oozed out, almost unnoticed, from its dormant home deep in the Labour left and the Tory right, stoked by Ukip to devastating effect.

The second stage was the campaign of that referendum itself: a focus on immigration over-riding a wider debate about free trade, and underpinned by the tempting and vague claim that, in an unstable, unfair world, control could be taken back. With any deal dependent on the agreement of twenty eight other countries, it has already proved a hollow victory.

For the last few months, these consequences of these two stages have dominated discussion, generating heat, but not light about what happens next. Neither has anything helped to bring back together those who feel their lives are increasingly at the mercy of a political and economic elite and those who fear Britain is retreating from being a world leader to a back water.

Little wonder the analogy most commonly and easily reached for by commentators has been that of a divorce. They speculate our coming separation from our EU partners is going to be messy, combative and rancorous. Trash talk from some - including those in charge of negotiating -  further feeds this perception. That’s why it is time for all sides to push onto Brexit part three: the practical stage. How and when is it actually going to happen?

A more constructive framework to use than marriage is one of a changing business, rather than a changing relationship. Whatever the solid economic benefits of EU membership, the British people decided the social and democratic costs had become too great. So now we must adapt.

Brexit should be as much about innovating in what we make and create as it is about seeking to renew our trading deals with the world. New products must be sought alongside new markets. This doesn’t have to mean cutting corners or cutting jobs, but it does mean being prepared to learn new skills and invest in helping those in industries that are struggling to make this leap to move on. The UK has an incredible and varied set of services and products to offer the world, but will need to focus on what we do well and uniquely here to thrive. This is easier said than done, but can also offer hope. Specialising and skilling up also means we can resist those who want us to jettison hard-won environmental and social protections as an alternative. 

Most accept such a transition will take time. But what is contested is that it will require openness. However, handing the public a done deal - however well mediated - will do little to address the division within our country. Ensuring the best deal in a way that can garner the public support it needs to work requires strong feedback channels. That is why transparency about the government's plans for Brexit is so important. Of course, a balance needs to be struck with the need to protect negotiating positions, but scrutiny by parliament- and by extension the public- will be vital. With so many differing factors at stake and choices to be made, MPs have to be able and willing to bring their constituents into the discussion not just about what Brexit actually entails, but also what kind of country Britain will be during and after the result - and their role in making it happen. 

Those who want to claim the engagement of parliament and the public undermines the referendum result are still in stages one and two of this debate, looking for someone to blame for past injustices, not building a better future for all. Our Marmite may be safe for the moment, but Brexit can’t remain a love it or hate it phenomenon. It’s time for everyone to get practical.