Tuesday briefing: Can Andy Burnham solve the social care crisis after three decades of failure?
Good morning. Andy Burnham will soon be adding his name to the list of prime ministers who have tried to answer one of the trickiest questions in British politics: how should we pay for social care? In his first sit-down interview as PM, he warned that the NHS would “collapse” without social care reform, and said he wouldn’t want to leave office without significantly changing the system. Those of you who remember Burnham as a fresh-faced health secretary may recall he co-authored a paper setting out plans for a National Care Service in 2010. It was one of the few instances where politicians came close to a solution, but after Labour was accused of trying to introduce a “death tax”, the paper joined a list of at least 22 major reviews, commissions and reports published since 1997 that have tried – and failed – to fix the problem. Care home fees have spiralled over the last two years. Based on my back-of-the-envelope calculations (bear with me), if I, a 33-year-old woman, eventually move into a care home when I turn 90 and die two years later, the fees will cost me roughly £1.2m. That’s based on a conservative estimate that fees increase by 4% annually: last year, they increased by as much as 10%. Something clearly needs to change. But what’s to say Burnham will be successful where others have failed? Today’s First Edition situates the PM’s promises in the history of an exasperating three-decades long debate, and asks what he could do differently. First, here are the headlines. Five big stories UK politics | Andy Burnham will tell schools across England to adapt their curriculums to the needs of local businesses as part of a devolution drive aimed at tackling the jobs crisis for young people. Wildfires | Firefighters in France and Spain are racing to bring huge wildfires under control before another heatwave this week that will complicate efforts to tame the flames. Iran | Donald Trump has once again warned that the US will return to “strong military action” against Iran if diplomatic efforts do not bring a rapid resolution to the crisis in the Middle East. India | India’s youth-led “cockroach” movement, whose nationwide protests forced the resignation of the education minister, has urged authorities to release all detained demonstrators. UK news | A US airman accused of a “spree” of rapes and sexual assaults in England, drugging some women and breaking into the homes of others, was able to avoid British justice after local police handed over part of the case to the American military. In depth: ‘Every month that goes past, the crisis deepens’
Whenever I’ve written about social care, what’s surprised me is how much the system rides on the wealth of baby boomers. Since there is no cap on the amount someone will have to spend on care once they’re down to their last £23,250 (£24,000 in Wales, and an upper limit of £35,000 in Scotland, which has a slightly different system), many people have no option but to sell their houses or use their life savings to fund it. Wealth that was built up over lifetimes and destined for children and grandchildren is instead diverted to the owners of Britain’s mostly privately operated care homes, and an estimated 10% of the money that councils and individuals spend goes on interest payments dividends, directors’ fees and profits – not frontline care. In a 1997 speech, Tony Blair famously declared that he didn’t want to see children growing up in a country where “the only way pensioners can get long-term care is by selling their home”. Two years later, a royal commission recommended that personal care should be free and funded by the state, but Blair’s government rejected its core proposal. The Brown government produced the white paper that was co-authored by Burnham in 2010, which set out plans to create a free at the point of use National Care Service modelled on the NHS. Timing is everything, and the Conservatives realised there was a powerful campaigning tool in accusing the government of trying to implement a “death tax”. It’s an attack line Nigel Farage resurrected yesterday. The white paper wasn’t actually explicit about how the service would be funded, and the government planned to legislate for it during its next term. But Labour lost the election just two months after it was published, and the idea of a National Care service was shelved. *** 2014 Shortly after taking office, the Cameron-led coalition government commissioned its own review of social care chaired by the economist Andrew Dilnot, whose 2011 report framed the next decade of policy debate. It proposed a lifetime cap on how much people would have to pay for their care, suggesting a threshold of £25,000-£50,000. Dilnot’s recommendations culminated in the 2014 care act, which was – in the Guardian’s words – an “historic piece of legislation”. It proposed a cap on care costs in England of £72,000, and its funding reforms were supposed to come into effect from April 2016, but … *** 2015 After unexpectedly winning a parliamentary majority, the Conservatives pushed these reforms into the long grass. In a 2015 letter, Alistair Burt, then minister for community and social care, explained that since the cap was expected to add £6bn to public spending over the next five years, the government had taken the “difficult decision” to delay its introduction to April 2020. *** 2017 During the 2017 general election, Theresa May announced her own plans for social care, which included raising the means test threshold from £23,250 to £100,000, and allowing people to defer the cost of payment until after death. Labour got its revenge on the Conservatives for their “death tax” allegations, and Jeremy Corbyn swiftly branded May’s proposal a “dementia tax”, helping destroy her majority in the 2017 election. “May was doing very well, and then suddenly started talking about plans for social care funding. Labour brands it a dementia tax, and the next thing you know, she’s tanking in the polls and Corbyn is shooting up,” Patrick Butler, our social policy editor, who has been covering this debate for more than two decades, tells me. “That was the second time it became clear that politically, this is a really hard thing to do.” *** 2021 After one pandemic and at least three major commissions, two green papers and three white papers, the Boris Johnson government finally set out plans to cap care costs to £86,000 by October 2023 (higher than Dilnot’s cap, but still progress). Johnson announced a 1.25% health and social care levy to pay for it. But then … *** 2022 Kwasi Kwarteng abolished the health and social care levy in September 2022 during his very memorable 38-day stint as chancellor. Later that year, Jeremy Hunt announced that reforms to the social care cap would be postponed again, until October 2025. *** 2024 and beyond Rachel Reeves said that it would “not be possible” to proceed with the cap on care costs after Labour won the general election. The party pledged to create a “National Care Service” in its manifesto, and in January 2025, then health secretary Wes Streeting announced another commission, this one chaired by Louise Casey, which will try to build a cross-party consensus on social care funding. That commission is supposed to deliver its final report in 2028. Burnham is clearly keen to do something quickly, so it’s possible it will deliver its findings sooner. “In all the years that these debates have been happening in Britain, other countries have pretty successfully solved the social care problem,” Abby Jitendra, policy director at ThinkLabour, who has written extensively on social care, tells me. The question for Burnham, as always, will be how to fund it (Kemi Badenoch helpfully wrote to the PM this weekend saying the Conservatives would be “happy” to work with the government on a solution – so long as it doesn’t involve raising taxes or borrowing). A paper Jitendra wrote last year pointed to a number of international examples. Australia subsidises care for people on lower incomes and caps it for everyone else, funding this through general taxation. In Japan, the costs of care are covered by taxation, insurance contributions and individual fees. With so much “political capital” already expended on the subject, it’s about time politicians came up with a plan. “How much time do you really need to dither on this?” Butler asks. “Every month that goes past, the crisis deepens. And the answers, and the options, are already out there.” What else we’ve been enjoying
It’ll (somehow) be 10 years this Christmas since George Michael died. I loved reading about the unreleased early 90s collab album he worked on with Aretha Franklin and Janet Jackson. Michael For almost two centuries, the Evening Standard was a fixture of London life. But it’s doubtful whether the paper will struggle on long enough to celebrate its 200th birthday next year. In his recent piece for The Londoner, Joshi Herrmann examines what went wrong under the editorship of Evgeny Lebedev. Hettie Before I let anything stress me out this week, I vow to think about the man in Montana who hiked 10 miles to safety with a trekking pole speared through his actual torso. Perspective! Michael I’ve been waiting to read our resident classicist and chief culture writer Charlotte Higgins on Christopher Nolan’s adaptation of The Odyssey. She finds Odysseus is “notably laconic” in Nolan’s film, which is perfectly calibrated for our war-weary times. Hettie I found these reflections from oncologist Ranjana Srivastava on medical decisions making really thought-provoking: “Far too often, patients report not understanding that they have a real choice, which includes saying no.” Michael Sport
Commonwealth Games | Adam Ramsay-Peaty says he is happy with second bronze and that his “superpower looks very different now”, while Scotland’s Archie Goodburn was racing despite his brain cancer diagnosis. Football |The top Democrat on the House judiciary committee has launched an investigation into Fifa president Gianni Infantino, seeking documents that would detail the ties between soccer’s governing body and Donald Trump and his administration. Premier League | English clubs have spent more on players this summer than the other four major European leagues combined. The front pages
“Teach pupils for local jobs, Burnham to tell schools”, is the Guardian’s splash today, while the Times’ take is “Burnham’s ‘hard hat’ schools”, the Telegraph writes “Burnham axes Blair’s university vision” and the FT has “Burnham seeks welfare bill savings by tailoring schools to local jobs market”. The Mail leads with “Burnham’s £18bn ‘death tax’ nightmare”. Elsewhere, a funeral homes case dominates, with Metro writing “Horror beyond belief at rogue funeral parlour”, the Mirror says “‘Sorry’ will never be enough”, and the Express has “Bodies were piled up like in a ‘horror scene’”. Lastly, the i Paper leads Europe wildfires, splashing “Race against time”. The Latest
‘Megablaze’ wildfires rage across France and Spain Firefighters in France and Spain are facing another day battling wildfires that have resulted in hundreds of thousands of people being evacuated, with another heatwave expected to hit this week. French authorities have said this year’s wildfires, particularly the Gironde fire near the south-western city of Bordeaux, are “completely exceptional”, with more than 116,000 hectares of forest and vegetation burned since the beginning of the year, compared with 70,000 in total last year. Lucy Hough speaks to Europe environment correspondent, Ajit Niranjan. Cartoon of the day | Ben Jennings
The Upside A bit of good news to remind you that the world’s not all bad
Three new murals installed in east London, Reading and Bristol in a bid to challenge stereotypes and misconceptions about rough sleepers. With numbers of rough sleepers in the UK rising to record levels, homeless charity St Mungo’s has commissioned the artworks to tell the story of former rough sleepers – Lee, Tamika, Ray and Lawretta – that it has helped support out of homelessness. Each mural features an integrated QR code that directs to the narrated stories of the people depicted. “I wanted to give these case studies a voice,” mural artist, Luke Embden says. “This is a really beautiful way to get the message out there.” “They’re asking people to stop and look and listen,” says Emma Haddad, the chief executive of St Mungo’s. “Recovery is possible, hope is possible, and support plays a fundamental role in that.” Sign up here for a weekly roundup of The Upside, sent to you every Sunday Bored at work? And finally, the Guardian’s puzzles are here to keep you entertained throughout the day. Until tomorrow. Quick crossword Cryptic crossword Wordiply