We mustn't let the adult care green paper become a damp squib

There is broad agreement that the social care system in England is unfair, unsustainable and unfit for purpose. While the talk was originally about a green paper which would put social care on a firmer financial footing, it has always had to be a document that would also set out a template for social care for the future. This would be a tall order for any time, but for the current chaotic political and economic times, it feels like many bridges too far.

Range of choices
So government has tried to square the circle by using the green paper to set out a range of choices, rather than clearly to offer a route map for the future. When it comes to funding the talk is of 'partnership', 'insurance' and 'comprehensive'. So, for example, there are options of increasing national insurance, people taking out private insurance and people paying in a lump sum on retirement. On the radio I heard the green paper announced as ministers wanting to spread the cost of care more fairly and prevent older people having to sell their homes. But clearly none of these options pass the equity test. Nor are they likely to ensure everyone is adequately covered at a time when many people neither can nor are able to think about taking out their own pension plan, let alone providing for their care. Meanwhile this green paper very clearly rules out social care that is 'tax-funded' 'because it would put a large burden of paying for care on people who are working'. Are we meant to assume they or their loved ones won't ever need social care or that non-employed older people don't contribute through taxation and in other ways too?

Lack of portability
One of the problems with the existing social care system is lack of portability and unhelpful local variation. But the most obvious inequity is the local distinction between Scotland and England, with Scotland having much envied free personal care for the past seven years, however much its ideological opponents criticise it. The idea of universalism does at least enter the green paper with more talk of a 'universal offer' for both self funders and those eligible for state support. But if this ends up amounting to no more than more leaflets and refocusing local information and advice centres, then it is unlikely to carry much credibility.

Dead in the water
Whatever we think of the green paper, its timing may mean that in some senses it is already dead in the water. It's the next parliament and the next government whether Labour or Conservative which will have to address the burning issue of social care reform. New Labour fudged it in 1998 with its Royal Commission on Long Term Care, when the public, media and political will for radical reform could all have been there.

All of us, however, have a responsibility here. The pessimists among us may see the green paper as yet another of social care's many missed opportunities. But the optimists will recognise the major part we have to play to prevent this from happening. Clear, loud and brave messages are now needed if the care debate the government says it wants is to be more than an introverted talking shop. Service users, carers and face-to-face practitioners must be fully included in this. We will all have to put our shoulder to the wheel if we want to give this green paper real purpose, rather than allow it to be a damp squib.