Polly Toynbee asks a seemingly difficult question and discusses a knotty issue (In Liverpool I saw the tough choices Louise Casey faces on social care – starting with who will pay?, 13 October). Her question is framed as an issue of individual choice inviting the response: “Not me if I can avoid it.”
The responsible answer is, of course, all of us – collectively. It is an uninsurable risk that can only be solved equitably and efficiently as a collective solution. By entangling the issue of funding with provision of services, moral clarity is lost. Issues of matching funding distort and influence the level of care provided and ensure that progress toward resolving the question of who determines the need for care is delayed.
The solution is to fund social care in the same way as the NHS was envisaged: as a right, free at the point of need, and funded out of general taxation as part of annually managed expenditure, like pensions and social security, as needs are presented and professionally agreed.
The Treasury has the ways and means, and nothing more needs to be discussed. The additional costs as a percentage of GDP are small and affordable by reference to other countries.
The issue of affordability is exaggerated out of all proportion by politicians who are afraid of being accused of raising taxes. In fact, because of the very high economic multiplier effect of boosting spending on low-paid workers, it is certain that it will pay for itself without impacting government deficits (unlike defence spending).
Andy Burnham knows this, and needs to overrule his cautious advisers. This is his big chance to demonstrate leadership. People don’t vote for ditherers.
Roger Steer
Sheffield
Thank you, Polly Toynbee, for your article about your visit to Liverpool with Louise Casey. Ms Casey is clearly right when she says: “If it’s public money, it should mainly be publicly run.”
I am old enough to recall the 1970s Tory privatisation of social care, and I remember sales of council facilities being forced through by rate-capping. Blatantly paying staff in the private sector less and lowering their standards and conditions of service was supposed to save money. I wasn’t aware at the time of the massive shift of public money into private establishments. The fact that the state’s bill for residential care increased more than twentyfold within seven years is scandalous, and should have been at the time.
Was the Tory government from 1979 the most ideologically driven UK government ever? Surely it is not too late to carry out an “audit” of the transfer of public assets to private individuals and companies? Until Ms Toynbee’s article, I would have suggested starting with council housing or water boards. Now I think social care is the place to start, soon.
Janet Dubé
Peebles, Scottish Borders
Polly Toynbee’s description of people with advanced dementia as having “glazed stares or sleeping mouths agape” and “that terrible human vacancy” is deeply troubling. Such language dehumanises people and reinforces the stigma surrounding dementia.
People living with dementia deserve, like everyone else, to be treated and spoken about with respect and dignity. I suggest she consult the guide to language for journalists produced by the Dementia Engagement and Empowerment Project, published in 2014 and written by people with lived experience of the impact of careless descriptors.
Sally Byers
Sheffield
