Will the social care reform green paper ever see the light of day?
Attempts by successive governments to reform provision in England have foundered amid political disagreements and concerns over the financial costs involved.
The Conservatives dropped plans in 2017 to make people receiving care at home liable for the full cost if they were worth at least £100,000 following a political outcry.
Theresa May was accused of trying to introduce a "dementia tax" by charities and pensioner groups who said people would no longer be able to pass their homes down to their children if property values were taken into account when calculating care costs.
Previous notion on reform have included:
Dilnot's care cap: In 2011, economist Andrew Dilnot was asked to lead a review of the system. The coalition government accepted the principle of his main recommendation, a maximum £50,000 cap on individuals' lifetime care costs, although David Cameron later set a higher figure of £72,500. The Tories dropped the idea in 2017, saying they would bring forward their own blueprint - which is as yet unpublished.
Conservatives' "dementia tax": Theresa May's 2017 election manifesto promised a controversial shake-up of care funding. Under the plan, the value of an individual's home was to be taken into account when assessing both domestic and residential care costs. Critics said it left people facing unlimited costs. The PM quickly did a u-turn, saying costs would be capped after all - although the plans were quickly shelved after she lost their majority.
Labour's "death tax": In the run-up to the 2010 election, the then Labour government proposed charging a 10% levy on the estates of deceased people to pay for care costs incurred during their lifetime. It was championed by the then health secretary Andy Burnham, now Greater Manchester Mayor. Amid a political backlash, the plans were dropped.
In its new report, the Centre for Policy Studies - a conservative think tank - said the current system was "financially and politically unsustainable".
It says taxes will need to go up to address the rising costs of care, with one option to plug the gap in the short-term being to ask over-50s to pay more National Insurance a state-funded weekly care payment.
Those able to downsize or release equity from their homes would also be encouraged to contribute more to plug the current funding gap.
But critics say it would not be enough to address the £7bn shortfall.
Labour shadow chancellor John McDonnell called on the government to reject the plan, which he said would "punish older people with a tax on getting old".
But former work and pensions secretary Damian Green, the report's author, told the BBC that if "just a sliver" of the equity tied up in property could be released, it would inject substantial amounts of funding.
On top of this, extra funding would then be generated through an annual care supplement, in which homeowners could choose to make voluntary contributions of either £10,000, £20,000 or £30,000, either through downsizing or releasing equity.
Mr. Green told Radio 4's Today that "many millions" of people would be able to buy what he
described as an "insurance policy" although, unlike previous proposals, they would not be forced to.
The Kings Fund, a leading health tank, said the £2bn to £3bn likely to be raised through Mr. Green's plan would simply not be enough to deal with the pressure on the system and more than twice that would be required to put it on a sound financial footing.
It is hard to see the present Government taking any risks with new reforms on social care. The unpopularity of their previous efforts on reform can be viewed as a causation factor in the delay of the Green Paper. Nor will the new proposals of the Centre for Policy Studies gain much traction. What is needed at a time of a dearth in British politics is the coming together of politicians from across parties to come up with a solution to the crisis in social care for the benefit of the people. The essence of which I guess we have heard this somewhere before.
Albert Cook Albert Cook BA, MA & Fellow Charted Quality Institute
Bettal Quality Consultancy