Dilnot report: An age old problem with no easy answer

Meals on wheels delivery Just over £14bn a year is spent by councils on social care

If politics was simply about rousing rhetoric, snappy slogans and popular soundbites, pretty much any fool could do it. (Some will, predictably, respond that any fool does!) But we expect more of our elected representatives than that.

As an old radio colleague of mine said to me some 25 years ago, we require them "to grasp the nettle through the window of opportunity".

Or as JFK put it in 1961, politicians "must face problems which do not lend themselves to easy or quick or permanent solutions".

How we ensure that our elderly live out their twilight years with dignity and security is one of those difficult issues. There are no easy or quick solutions and answering the challenge necessitates some quite profound reflection on our values.

After decades dodging the question and allowing a climate of fear and uncertainty to develop within England's social care sector, the coalition government asked the economist Andrew Dilnot to bring his not-inconsiderable intellect to it.

When I met him recently, the first thing he said to me was this: "We are four times richer in real terms than we were just after the war."

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That is his starting point for the debate: we can afford to care for our elderly - it is a matter of priorities, not affordability.

Mr Dilnot estimates that, at current levels of need, his proposals will require England to devote just 0.25% of public spending on provision for the elderly. "Do we care enough?" he asks.

It is, though, a matter of who pays - and that's where the politics starts to get toxic.

Where should the balance lie between state and the individual? The Dilnot Commission's solution is creative and clever. But in the end someone has to fork out and there will be endless argument as to what is fair.

It is the time for political courage not political cowardice - grasping that stinging nettle through the open window of opportunity.

Dilnot report: How radical should it be?

The debate has been framed in terms of state v individual - but I do wonder whether there is a third element here, an aspect to which other countries and cultures pay more attention: community.

The responsibility of families, friends and neighbours to care for the elderly is barely discussed, as though looking after the old is none of our business.

As he was finalising today's report, I spoke to Andrew Dilnot and others for Radio 4's World Tonight programme. Do have a listen. My investigation began in Denham Garden Village.

Mark Easton Article written by Mark Easton Mark Easton Home editor

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  • rate this

    Comment number 24.

    It is a bit frustrating, as a working taxpayer, to see how widespread the belief is that the State somehow owes their children a free house. If someone owns a house and needs care, there is nothing remotely wrong or immoral about expecting them to pay for it. There is no human right to leave an enormous inheritance, especially with taxpayer support.

  • rate this

    Comment number 23.

    Why has it become the State's responsibility to look after those who fail to plan ahead?
    After all, if they care too little about their own future to plan for it and their children or other relatives care too little about them to make even a modest sacrfice on their behalf then why should perfect strangers be forced (the key word here) to support them?

  • rate this

    Comment number 22.

    In response to those who ask "why should those who fail to save for their old age receive the same (or better) lifestyle at taxpayer's expense while responible persons have to pay out of paocket until all of their assests are gone"? The answer is simple; they shouldn't.

  • rate this

    Comment number 21.

    '8. one day baby
    4TH JULY 2011 - 15:26'

    Thanks to this risible new 'commenting' system this cannot be developed as it should be, so I'll content self with a totally manipulable 'like'.

    Just as some saddos seem to be disliking anything, no matter how well argued, that doesn't suit.

    Like much these days, the system is the problem and unfit for purpose, yet prevails by creating bread & circuses

  • rate this

    Comment number 20.

    There are 2 'fair' ways:

    - Make an allowance that covers reasonably the costs of care for anyone who needs it.
    - Give absolutely nothing in terms of care or health service to anyone, old or young.

    Decide which you like best.

  • rate this

    Comment number 19.

    Why should the hard-earnedsavings of elderly people be depleted to fund their care when the government spends billions of pounds every week on military adventures in countries where they have no need to be. We are told to save. Why bother? My 93-year-old mother saved all her life and is now affected by virtually zero-interest rates while benefit cheats continue to abuse the system.

  • rate this

    Comment number 18.

    #7.estados unidos de america
    if you are old and you need care and you have the finances then you should pay.If that means using up your life savings and sellling your house then so be it
    = = = = =
    Rubbish. What about those who never worked or paid tax but just frittered their lives drawing benefits. Why should they get free care?
    Why should those with assets subsidise them?

  • rate this

    Comment number 17.

    The only winners are those who could but haven't worked, haven't saved a penny and contributed not a jot to society. They'll get care free on a silver platter.

    Those of us who worked, paid tax, bought homes, never asked for benefits, saved and planned for our retirement, are the losers.

    A salutatory lesson for young people "worried" about not having a job or owning a home. Don't bother.

  • rate this

    Comment number 16.

    What's so utterly galling is the amount of our tax given away as foreign aid or frittered on unwinnable wars, or handed to the sponging class would pay for the care of our elderly many times over. It's time the governors of this wretched country got their wretched priorities right. Pensioners have already paid.

  • rate this

    Comment number 15.

    There's an answer that might suit some: allow assisted suicide or euthenasia. The prospect of degenerating to such a state that you can't live without the need for "human crutches" dressing you, washing you etc is abhorrent to some when you know you're on the way out. To have to pay hugely merely to watch or feel yourself rot is doubly abhorrent. Raising this as a serious choice is long overdue

  • rate this

    Comment number 14.

    I do get annoyed, when people say that if you have savings or a house, you should sell your house to pay for your care.if you are unfortunate to be ill I worked all my life, & am fortunate to own a house and have some savings
    I paid tax and still do & superannuation for my pension which is taxed again & saved For that I am to be penalized and told to lose all I have worked for!!.

  • rate this

    Comment number 13.

    2nd attempt!
    Doctors give 'old age' as a cause of death. Thus, the associated infirmity is a medical condition and the costs should fall on the NHS, not the local authority or the individual.

    For most of us, it's sufficient that we don't know about it and don't pay for it.

  • rate this

    Comment number 12.

    Let's just do what the Scots do, pay for every single penny of Elderly Care via the state. While we're at it, let's give free tuition to our students, just like they do in Scotland. Then there's the free prescriptions, free eyetests, free dental check ups etc, For all those who think we can't afford it, if they can then so can we so we. Afterall aren't we supposed to be living in a union of equals

  • rate this

    Comment number 11.

    The Old Age Pension was introduced in 1906 to enable the elderly' to buy a place by the fire in their children's home'.
    By the '80s things had moved on, the papers were full of stories about the coming growth in domestic servants as children became overnight millionaires on selling their parents home. Nigel Lawson ended that dream. Care of the elderly was driven into the hands of the market.

  • rate this

    Comment number 10.

    Jim (No. 8) is unlikely to be on minimum wage or benefits but to Dave I would say "you cant take it with you". Is the category 'social care' just another way of depriving us from free health care as most cases are people who have a chronic health condition prior to or leading to their death.

  • rate this

    Comment number 9.

    I see everyones point of view, but just see maybe another view. I am not talking about the very rich. BUT Why should an average person on averages wages that has paid tax all their lives and saved some money and bought a normal house have all that taken off them, while other people who are not disabled or the like, but are fit and never worked and never saved get all theirs paid for?

  • rate this

    Comment number 8.

    Lets actually loook at the elephant in the room....

    Jim lives life to the full, two cars, two annual holidays etc etc
    smokes like a chimney etc, no savings.
    When he needs old age care he hasn't got a bean, so gets it all for free.

    Dave bought his own house, has one car and sometimes can afford a holiday.

    When he needs old age care he has to pay for it, even with these new proposals.

  • rate this

    Comment number 7.

    if you are old and you need care and you have the finances then you should pay.If that means using up your life savings and sellling your house then so be it.the problem here is the kids seeing their inheritnaces go up in smoke.I as a tax payer shouldn't be expected to pay so they can gain their inheritance windfall.it's immoral and theft.

  • rate this

    Comment number 6.

    Affordability is a matter of priorities, AFFORDABILITY & social adjustment. e.g. Often the elderly need to be taken medical appointments. How does one do this unless the employer agrees - with no dock to salary. I think we care enough, but some people do not see themselves as part of the problem or solution. We should all contribute because one day - if we are lucky - we may be old.

  • rate this

    Comment number 5.

    Social care costs may or may not need 'need capping’. What I KNOW is needed regarding the elderly is first rate personal home care, appliances (like stair lifts) and step-in baths. Some children of elderly do not mind carrying for their parents or grandparents in the home; it's just the cost, the unaffordable cost of house conversion. I KNOW because I am one of these.


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