Downing Street’s plan to spend three years preparing a blueprint to overhaul England’s social care is “inappropriate” given the urgency of the crisis facing frail, ill and disabled people, a leading care expert has told MPs.
Sir Andrew Dilnot, the architect of previous government-commissioned attempts to reform adult social care funding, said that with clear backing from Keir Starmer, new plans could feasibly be in place by the end of the year.
“I think it’s so blindingly – excuse my language – bleedin’ obvious that something should be done here, that, in the end, in an intelligent, affluent, civilised society, we get this done,” Dilnot said.
Appearing before the Commons health and social care committee on Wednesday, he urged ministers to speed up the reform process: “I think it’s perfectly, perfectly feasible for the government to expect … by the end of 2025, to say: ‘Actually, we know what needs to be done, this is what we’re going to do.’”
He added that he thought reform would not happen unless the proposed changes received political backing from the very top – and he urged the prime minister to “get behind” the changes. “It’s really a matter of political courage and political decision-making,” he said.
“I don’t think we need a very long time to work out what, we just need to decide ‘this is what we are going to do’. My own view is that three years is a completely unnecessary period of time. If we simply focused on it we could get that decided very, very quickly.”
He said: “I think Sir Keir’s views will be absolutely critical in this and if the prime minister gets behind this then something, I think, will happen. So I am optimistic. I’m always vague about timescales but we will get this done and we must because how can we look ourselves in the mirror and not deal with this?”
Dilnot said the care challenges facing families and local authorities were “simply unacceptable in a society with the levels of income and wealth that we have. We are just not doing that well. That’s the clear and pressing, immediate, urgent task.”
His intervention came amid growing pressure on Labour to accelerate progress of an independent commission, announced last week and headed by the crossbench peer Louise Casey. Her final report is not expected to be published until 2028.
Adult social care reform has been on and off the English policy agenda for more than two decades with repeated attempts by governments to change the system being derailed by lack of political consensus and political timidity.
The Liberal Democrat leader, Ed Davey, said Dilnot was right to say the review could be completed within a year and accused Labour of dragging its heels: “The social care crisis is forcing patients to be treated in hospital corridors while elderly people sell their homes to pay for care.”
Dilnot led a government review into the future of funding social care and published his proposals in 2011. Despite Dilnot-style changes having been accepted by previous governments, and white and green papers being issued, they are still yet to be enacted.
He said there had been repeated political consensus on the need for social care funding reform over recent years across all parties. Ministers had made repeated promises to deliver change. The problem was “just not actually delivering”.
The chief executive of the Social Care Institute for Excellence, Kathryn Smith, told MPs: “I’ve worked in social care throughout all those green and white papers, and every time one comes out you think you are going to get somewhere, and to be honest, it is just Groundhog Day.”
