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Leader comment: Social care reform: are we sheep or goats?

27 January 2023

REFORMING the social care system is too difficult to be left to politicians. Discuss.

Let us look at the record. Judging by what they have said, politicians of all stripes have a clear grasp of the problem. Social care is too important to be left to short-term fixes. Politicians have said that. It requires a multi-party, multi-agency agreement. Politicians have said that, too. It requires a greater investment of public funds. Yes, that, too. It needs to function in close collaboration with the NHS. That, too. It is an urgent problem that needs to be treated as a top priority. Ditto. In fact, everything that the Archbishops’ Commission on Social Care says in its report this week, bar some of the religious underpinning, can be found in Hansard, or party manifestos, or stump speeches. Yet no action is taken (bar short-term fixes that government spokespeople can cite when criticised) because, we would argue, the burden of the present broken system falls on countless individuals who bear the financial, relational, and often physical pain of it with bewildered fortitude.

The commission’s report deliberately avoids the arguments about how a newer, better system can be funded. But its six reasons for a radical rethink comprise three financial justifications alongside the three moral ones. Efficiency: it is universally acknowledged that the poor performance of the NHS at present is hugely exacerbated by the lack of social care, which means that recovering but vulnerable patients cannot be discharged. The NHS budget is so large (£192 billion) that even small percentage savings can be reckoned in millions of pounds. Economic growth: a properly functioning — i.e. larger and better paid — workforce would improve the UK’s economy. Social value: as the report states, caring for a relative is one of the main reasons that workers over 50 drop out of the labour market, diminishing their contribution to the economy and jeopardising their pension entitlement. Elevating this burden would allow carers to remain economically active. Thus even without the other three arguments — levelling up, human rights, and basic morals (“We must act because the levels of human suffering due to a lack of care and support are unethical”) — the commission’s case for radical reform is unassailable.

We mentioned religious underpinning. Amid all the acknowledgements among politicians that “something must be done”, we fail to see the simple outrage that ought to be generated by an unjust system that, today and every day, is causing distress, hardship, and premature death, with more than half-a-million people waiting in vain for social care. Well might the commission talk of “cognitive blindness” and sin. For Christians, the message is clear: Christ’s Q&A — “When saw we thee a stranger, and took thee in? or naked, and clothed thee?” (St Matthew 25.31-46) — teaches that, in caring for someone, we are caring for God; neglecting someone, we neglect God. If we see the need for reform in that light, how can we not act?

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