Seven key principles
One of the Green Paper’s key principles will be a sustainable funding model. Other principles set out in the Green Paper include: the quality and safety of services, the integration of the health and social care systems, control for those receiving support, valuing the workforce, providing better practical support for families and carers and ensuring greater security for all. The new system of funding social care will be capped. Asked directly if that meant there would be a cap on what any individual had to pay, he replied: "Yes." But his remarks disappointed those who had hoped for a tax-funded system that would give social care parity with the NHS. He insisted the element of personal responsibility envisaged in the original National Assistance Act 70 years ago would stay.
The health and social care secretary said: "The way that our current charging system operates is far from fair." This is particularly true for families faced with the randomness and unpredictability of care, and the punitive consequences that come from developing certain conditions over others.
"If you develop dementia and require long-term residential care you are likely to have to use a significant chunk of your savings and the equity in your home to pay for that care. But if you require long-term treatment for cancer you won’t find anything like the same cost."
Hunt acknowledges that the principles will not succeed unless the systems we establish embrace the changes in technology and medicine that are profoundly reshaping our world, he said. "By reforming the system in line with these principles everyone – whatever their age – can be confident in our care and support system. Confident that they will be in control, confident that they will have quality care and confident that wider society will support them."
The need for action now
Hunt is under pressure to do something now. This month Sir Stephen Houghton, the leader of Barnsley council in South Yorkshire, said the postcode lottery was turning a historic economic divide into a serious social one. "If you happen to live in a poorer area you’re more likely to receive lower-quality care in old age or if you suffer from a long-term disability. People should be entitled to the same quality of service no matter where they live," he said.
Hunt acknowledged "the daily pressure" faced by local authorities and said: "We need to recognise that with 1 million more over-75s in 10 years’ time they are going to need more money, and we are going to have to find a way of helping them to source it."
Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said: "Warm words are always welcome but let us hope this speech represents new thinking in a government which like the rest of the political class has been understandably distracted by Brexit. The signs are that the Secretary of State understands what is needed – but the challenge of convincing his cabinet colleagues remains."
Jeremy Hughes, Alzheimer’s Society chief executive, said: "Jeremy Hunt’s seven principles must not be wishful thinking for those impoverished by having dementia. The Government must now commit the funding to make good on these principles. “Without the necessary funding, vulnerable people will continue to struggle needlessly. By 2021, a million people in the UK will have dementia, and we need urgent action to create a system that can meet that challenge."
The seven key principles that will form the framework of the Green Paper due to be published in the summer of 2018 should be given a cautious welcome. After all, it could be argued that the reneged promised cap on social care frees cost this government a large majority at the last election. However, it is just possible that the pressure of the Government to deliver on these principles this time may result in a solution to the problems of social care for fear of losing the next election. I have no doubt that Jeremy Hunt is sincere in trying to achieve change, but he cannot do anything without the support of the Prime Minister and her colleagues. This issue should be above party politics. Let us hope that the Jeremy Hunt principles lead to much needed action.
Albert Cook BA, MA & Fellow Charted Quality Institute
Bettal Quality Consultancy