Wednesday 2nd October 2024
Better social care means better stewardship, says Sir Andrew Dilnot
Helen Nathan
The economist argues that a properly funded social care system would enable us to live out our God-given mandate to be good stewards. But when will our politicians face up to the cost?
Sir Andrew Dilnot is no stranger to talking about social care. It was back in 2011 that he published the ‘Fairer care report’ (also known as ‘the Dilnot report’) outlining his recommendations for social care reform. Since then, he’s sought to persuade successive governments to take up its recommendations, only to be met with endless delays and disappointments – one of the first actions of the new Labour government was to scrap the planned cap on care costs (a key proposal of the Dilnot report) which had been due to come in October 2025.
It’s fair to say Dilnot is a man deeply frustrated. Yet he’s not giving up.
On 30th September he spoke at St Andrew’s, Dean Court in Oxford as part of a series the church is hosting on ‘Caring for one another as years go by’. In his talk ‘Social care – what is to be done?’, Dilnot outlined the biblical principles on which his proposals for social care reform are founded.
Dilnot believes we have a God-given responsibility to provide not just for widows and orphans (James 1:27) but also to steward our wider communities so that the minority who will one day find themselves in need of high levels of care can receive it without facing exorbitant costs.
“The way we look at social care in the UK denies people that sense of stewardship,” he says.
Why? Because the state will only pay social care costs for the least well-off in our society (those with assets of less than £23,250), many of us hoard our wealth, terrified we won’t have enough in the pot. While some of us may end up needing hundreds of thousands of pounds to cover our care, that won’t be all of us, and yet the current system encourages us to behave as though we will.
As an example of a country taking a step in the right direction, Dilnot points to Australia who have very recently introduced a cap on care costs of $34,174.16 per year, or $82,018.15 in a lifetime. This contrasts with the uncertainty we face.
“Social care in the UK is like being in a shop where you don’t know any of the prices,” says Dilnot.
As a consequence, we fail to be good stewards not only of our communities but also of our own physical health. People remain in big houses longer than is appropriate in case they need to invest the value in their future care, and thus run the risk of falling down the stairs and sustaining injury. Instead of spending on care when needs are still relatively low, we hang on to our funds and don’t take the steps that might prevent worsening health.
What we need to do instead, argues Dilnot, is to pool the risk. Just as the NHS is there should we face a serious illness, just as we take out insurance for our cars and homes, so we need some way of spreading the cost of social care provision. A private insurer would never offer a premium on a service most people won’t need until 30 or 40 years’ time – it’s too unforeseen and they risk going bust. The only real way to do this, says Dilnot, is through the state because it’s big enough to cushion the blows whatever the future holds.
But the money has to come from somewhere. Logic suggests that the introduction of some kind of tax, unpopular as it may be politically, is unavoidable.
“The government will do something eventually because they’ll have to,” says Dilnot.
In the meantime, he encourages us not to get down-hearted, but to keep talking about it – to write to our MPs, our bishops, and to the Archbishop of Canterbury who oversaw the recent commission on Reimagining Care. And, above all, to pray.
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