Social care - the problem isn't money

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Yesterday, Andy Burnham laid out his ambition for a National Care Service which would provide care free at the point of use to all who need it. His proposal related only to England, but the underlying problem which it seeks to address is a problem in Wales as well, and we face the same issues, probably more so with an even more ageing population than England. There’s a little bit of the ‘jam tomorrow’ about the promise, given that it seems to be little more at this stage than a pledge to put the issue in Labour’s manifesto for the next English / UK General Election. And until we see the detail, it’s hard to be certain whether the ‘problem’ he’s seeking to address is really about care at all – for some, it seems to be more about protecting middle class inheritances.

The political and media response has largely centred on the question of ‘how will you pay for it’ (and the consequent suggestion of tax rises), as though the problem is first and foremost a financial one. It’s completely the wrong question to be asking. The much bigger and more important question is whether the resources are available, or can be made available. Let’s just consider one type of resource – labour. There’s already a shortage of carers, meaning that they are providing what is generally understood to be an inadequate level of care today. And, in typical left-hand-right-hand manner, government obsessions with migration numbers are constraining one of the key ways of increasing the supply. It’s not enough to simply look at the number of vacancies (now and under a better system) and the number of people unemployed and match the two numbers; there are also issues around geographical location, skill sets and attitudes. Maybe attitudes aren’t important to economists looking only at numbers, but to those whose relatives are receiving care, having people committed to providing a client-centred service in a friendly and empathetic way rather than simply going through the motions does actually matter. A lot.

Increasing the wages and status of the job might help to attract more of the ‘right’ people, but that’s about method rather than objective. Whether we use that mechanism or another, the objective of getting more people into a professional career as carers implies a willingness to divert a potentially scarce resource – suitable employees – from other economic activity into providing care. And it is that question, of determining how resources should be deployed in the economy, which is the central one, rather than how it is to be paid for.

It’s a question which isn’t unique to the issue of social care. What sort of economy we want and whose interests it serves are key questions – another example is this story today about campaigners calling for investment in socially useful activity rather than armaments factories. Treating the provision of social care as simply a matter of finance is missing the point, to say nothing of missing an opportunity to push back against the prevailing view that everything revolves around money. Without addressing that issue, tomorrow’s jam might turn out to be rather less palatable once the jar is opened.