Merging social care services with the NHS makes sense

And anyone who is really in the business of serving the public will agree

Share

Maybe it’s the sort of conversation that you have when you reach a certain age. But I’ve lost count of those who tell me, often after losing an elderly relative, that there has to be something better than the desperate and humiliating mess that passes for our care system.

To those who have seen it at its worst, even Jeremy Paxman’s much-criticised euthanasia clinics on street corners don’t seem so bad. The number of those making living wills in the hope of ending their days with dignity has risen exponentially. Assisted dying may have been rejected by the courts and by the House of Lords, but popular pressure only grows. For some, a one-way trip to Zurich looks an ever more attractive option.

By and large, though, it is not the last days, even weeks, of utter dependency that concern us. With any luck, we’ll be high enough on morphine not to notice. It is the months and years before, when, with the right sort of accommodation and some help, we would have a good chance of coping, even enjoying life. But that housing and that help is just not there. Or if it is, it is so difficult to find and obtaining it so hedged about with restrictions that it is simpler just to soldier on. Those who do receive help from the state – real help, of the sort they need, when they need it – seem to the rest of us to have won life’s lottery.

This sense of trepidation about future care needs and the glaring contradiction, so it seems, between health care (free at the point of need) and social care (anything but) is addressed in two reports out this week. The timing is not coincidental. One aim is to catch the attention of politicians as they go into the last conference season before the election. But will they have any effect?

Dame Kate Barker’s commission, which reported yesterday at the King’s Fund, recommends – among other things – fusing the health (NHS) and social care (local authority) systems, so that people are not passed eternally between the two as each tries to avoid paying. It suggests an extra penny on national insurance for the over-40s to help pay for this joined-up service, plus means-testing of such benefits as free TV licences and fuel allowances. It was the “cuts”, alas, not the benefits, that captured the headlines.

Read more:
Unhealthy service: Merging the NHS with social care will be expensive  
Raise taxes to give free social care to elderly and chronically ill, think-tank says

The previous day, the left-leaning think-tank Demos had published the findings of its Residential Care Commission. Chaired by the former care services minister,  Paul Burstow, it suggested, among other things, that hospitals use spare land (yes, they do have some) to build sheltered housing and care homes. It also wants private companies to build more retirement developments so as to tempt people out of the houses that are so badly needed by families. What is on offer at present, the report said, is simply not good enough to persuade people to move. Indeed.

My own view is that pretty much all of this makes sense, and pretty much all of it should be feasible – except, perhaps, for the one change on which most of the rest depends: the fusion of health and social care.

As Health Secretary, Jeremy Hunt has made a start, by diverting a small sum from the NHS to a social care fund, but this is tinkering. The two services really have to be brought together, not primarily for the savings that might result, but for the sake of the confused and abysmally served public. It’s not easy, though: the two sectors have resisted such calls before, and they will fight tooth and nail to defend their separate hierarchies and separate budgets.

In the last Budget, George Osborne shocked the insurance world by summarily abolishing their nice little earner, the compulsory annuity people had to buy with their private pension pot. I was amazed he had the authority, let alone the guts, to do something that would so obviously affect their bottom line.

Something similarly bold will be needed here. Of course, NHS staff will say the service can bear no more reorganisation; the social care establishment will warn of destitute 90-year-olds wandering the streets. But if these people are really in the business of serving the public, rather than themselves, they will knuckle down and get on with it.

Trierweiler should tell a little less

Granted that Paris Match, like any magazine buying book rights, will have chosen the most salacious morsels, and granted that Valérie Trierweiler had a difficult time of it as the first unmarried partner of a French president to reside at the Elysée – still, I feel that she has not done either herself or womankind many favours with her angry and self-pitying account of their break-up.

Thank You for the Moment, as her book is called, may be a novelty for the French, whose privacy laws protect public figures from prying eyes. But I doubt it will damage her ex any more than he has already been. After all, he left the mother of his four children to join Trierweiler, and the tales of his nocturnal motorcycling antics made him a national (and international) joke. “Discretion” used to be considered a virtue in France. I rather hope that, after Trierweiler’s outpourings, it might stage a speedy comeback.

Not fit for a king... or anyone else

Even if he never does anything else, Prince Charles has already left an honourable legacy in his description of a projected new wing for the National Gallery as a “monstrous carbuncle on the face of a much-loved friend”. The Carbuncle Cup, awarded in an online competition run by Building Design magazine, identified a true horror this year in Woolwich Central – a massive outcrop that combines the worst of 1960s council estates with clumsy, faux-modernist adornment. The judges described it as “oppressive, defensive, arrogant and inept”.

I was also gratified that Broadway Malyan’s Vauxhall Tower – which dominates the view from our kitchen window and resembles an out-of-proportion glass candle with a clichéd wedding-cake top – was the runner-up. It has only two saving graces: it’s so tall that it’s periodically lost in fog and it makes the still uglier (and already ageing) riverside ensemble beside it look a bit smaller than it is.

 It turns out, though, that one of this year’s most-nominated  buildings was eliminated as it’s not quite finished. The so-called “Walkie Talkie”, in the City of London, is an absolute shocker that eclipses both Woolwich Central and the Vauxhall Tower in its leering awfulness. “Carbuncle” would be letting it off lightly.

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Recruitment Genius: Casual Visitor Experience Assistants

£7 per hour: Recruitment Genius: To work within the Visitor Experience Departm...

SThree: Trainee Recruitment Consultant

£18000 - £23000 per annum + Uncapped Commission: SThree: As a Trainee Recruitm...

Recruitment Genius: Customer Services & Office / Accounts Administrator

£16500 per annum: Recruitment Genius: This online retailer of electronic acces...

SThree: Trainee Recruitment Consultant

£18000 - £23000 per annum + Uncapped Commission: SThree: As a Trainee Recruitm...

Day In a Page

Read Next
Protesters march with banners during an anti-austerity, anti-Conservative Party protest in May  

Budget 2015: Why do we call social security payments 'benefits'? They are a right, not a reward

Janey Stephenson
Laura Bassett signs autographs for England fans after the quarter-final victory  

Women's World Cup: Despite the England team's tweet, the Lionesses can be mothers and successful football players at the same time

Chloe Hamilton
Greece debt crisis: EU 'family' needs to forgive rather than punish an impoverished state

EU 'family' needs to forgive rather than punish an impoverished state

An outbreak of malaria in Greece four years ago helps us understand the crisis, says Robert Fisk
Gaza, a year on from Operation Protective Edge: The traumatised kibbutz on Israel's front line, still recovering from last summer's war with Hamas

Gaza, a year on from Operation Protective Edge

The traumatised kibbutz on Israel's front line, still recovering from last summer's war with Hamas
How to survive electrical storms: What are the chances of being hit by lightning?

Heavy weather

What are the chances of being hit by lightning?
World Bodypainting Festival 2015: Bizarre and brilliant photos celebrate 'the body as art'

World Bodypainting Festival 2015

Bizarre and brilliant photos celebrate 'the body as art'
alt-j: A private jet, a Mercury Prize and Latitude headliners

Don't call us nerds

Craig Mclean meets alt-j - the math-folk act who are flying high
How to find gold: The Californian badlands, digging out crevasses and sifting sludge

How to find gold

Steve Boggan finds himself in the Californian badlands, digging out crevasses and sifting sludge
Singing accents: From Herman's Hermits and David Bowie to Alesha Dixon

Not born in the USA

Lay off Alesha Dixon: songs sound better in US accents, even our national anthem
10 best balsamic vinegars

10 best balsamic vinegars

Drizzle it over salad, enjoy it with ciabatta, marinate vegetables, or use it to add depth to a sauce - this versatile staple is a cook's best friend
Wimbledon 2015: Brief glimpses of the old Venus but Williams sisters' epic wars belong to history

Brief glimpses of the old Venus but Williams sisters' epic wars belong to history

Serena dispatched her elder sister 6-4, 6-3 in eight minutes more than an hour
Greece says 'No': A night of huge celebrations in Athens as voters decisively back Tsipras and his anti-austerity stance in historic referendum

Greece referendum

Greeks say 'No' to austerity and plunge Europe into crisis
Ten years after the 7/7 terror attacks, is Britain an altered state?

7/7 bombings anniversary

Ten years after the terror attacks, is Britain an altered state?
Beautiful evening dresses are some of the loveliest Donatella has created

Versace haute couture review

Beautiful evening dresses are some of the loveliest Donatella has ever created
No hope and no jobs, so Gaza's young risk their lives, climb the fence and run for it

No hope and no jobs in Gaza

So the young risk their lives and run for it
Fashion apps: Retailers roll together shopping and social networking for mobile customers

Fashion apps

Retailers roll together shopping and social networking for mobile customers
The Greek referendum exposes a gaping hole at the heart of the European Union – its distinct lack of any genuine popular legitimacy

Gaping hole at the heart of the European Union

Treatment of Greece has shown up a lack of genuine legitimacy