By Peter Beresford, chair of user-led organisation Shaping Our Lives, and professor of social policy at Brunel University. Much has happened in social care since the Dilnot commission on its future funding, which reports today, was established. We have had the scandals of Southern Cross and Winterbourne View Hospital, damning Equalities and Human Rights Commission findings on domiciliary care and a major government U-turn on NHS reform. The visibility of social care and attitudes and circumstances surrounding it have all changed dramatically. There's a renewed sense of urgency to the feeling that something serious must be done.
This raises the question of whether the Dilnot commission is still fit for purpose - or indeed whether it ever was. Its unusually small membership of three has always begged questions. Now with the Care Quality Commission clearly being held under the microscope after its conspicuous failure to act over the appalling abuse at Winterbourne, we might wonder how independent such a commission can be seen to be when the chair of the CQC, Jo Williams, makes up one-third of its membership.
Lord Norman Warner has always made his position on social care clear and has continued to do so during the course of the commission. Dismissive of paying for social care through general taxation, as director of social services in Kent, he was closely associated with the original community care reforms which have brought social care to the impasse it now faces. Adviser to PA Consulting group on Middle Eastern issues, he has had strong links with the private sector.
Andrew Dilnot came to the role of chairing the commission with a powerful track record as a financial expert and independent voice. However his constant refrain as chair, that the proposals of the commission must accord with what political parties will accept, raises concerns. This is first because of the continuing lack of consensus between the three major political parties over health and social care - even within the coalition. But more importantly, perhaps, there can be little hope that the short-term political and economic considerations now given high policy priority will be consistent with proposals that offer a sustainable and workable social care funding system for the next generation.
Any question marks over the commission are likely to weaken the authority that government gives its recommendations. That's why what's most important is that there are major opportunities for a real public debate about its proposals. Only one thing would be worse than policymakers' failure to address social care's funding crisis during all those expansionist years after New Labour came to power in 1997. That would be for government to step back from the best of new thinking. It's that which has brought us to the scandalous state we are now in.
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