Deborah Orr: Old age is not an illness and its care needs to be paid for

Nobody rails at the idea babies should be cared for primarily by their families

Related Topics

Care home. Two words that fill people with such dread that they prefer not to think about such places, until they have to. The new Health Secretary, Andy Burnham, insists that we do have to think about care homes though. And we have to think more generally too, about how we care for those among us who are elderly now, but living at home, and how we want to be cared for ourselves, when we find that our own independence has been curtailed or lost, and we need other people to assist us. He's quite right. This issue needs urgent thought.

A Green Paper, Shaping the Future of Care Together, has been published. It is hoped that when the time comes for a white paper to be drafted, in November, a vigorous national debate about its contents will have taken place. Is this too short a time for such a debate to have been satisfactorily completed? Of course it is. Especially when the debate, at this early stage, is so very crude.

The green paper focuses on funding. The government admits that there will be many more elderly people to be looked after, and no more money to do so. It wants to maintain state funding at its present £14.7bn, and wants people to become aware that unless they are very poor indeed, they will have to pay some of their care costs themselves. This is one of those things that you think is common knowledge, only to discover, when something like a Green Paper comes along, that people are astonishingly ignorant.

It is already plain that people fondly – or not so fondly – imagine two things. One is that old age is an illness and that its symptoms should be treated by the National Health Service. But that is not the case. If the inability to get to the loo unaided, or to eat or to dress or to wash or to get out of bed unaided were an illness, then infancy as well as old age would have to be treated as a disease.

Nobody rails and screams at the idea that babies should be cared for primarily by their families. But for some people, even the prospect of sacrificing one's inheritance – usually in the form of the parental home – in order that others can be paid to keep their parents safe and comfortable, is an abomination.

This is a pretty shameful attitude, and it speaks volumes that people think nothing of vociferously complaining that it is "unfair", to the point where those who are "good at playing the system" can offer all kinds of advice on how to ensure that the state rather that the family assets meet the cost of paying for help, even – especially – if they are rich in property assets.

The other is that national insurance contributions should pay for social care, because national insurance contributions fund state pensions. Again, this is actually quite a daft assumption. The state pension is there to provide the essentials of living – and barely at that. Food, accommodation, utility bills – those are the things that the state meagrely provides under NI. People would do well to note right now that the changes proposed in the green paper assume that people would go on paying for their own food and board.

It's the cost of care – the laying on of human hands that is at issue here – not the cost of food and shelter. In fact, one interesting aspect of the new proposals is that they all would make this distinction more plain.

The Government has already ruled out funding social care through general taxation, arguing that it would place too much of a burden on the working population. Instead it wants to set up a "national care service", and sets out three possible ways of funding it. Two of them seem like non-starters to me. A "partnership model" promises that the state will pay for a third of basic costs, whatever the individual's financial situation, unless it is dire, while a voluntary insurance scheme attaches an extra bit onto this undertaking, for those who fancy it.

Neither of these appear to address the basic problem – which is how to get people whose retirements are healthy, wealthy and short, to supplement those whose retirements are feeble, poverty-stricken and long. Only the third, a compulsory insurance scheme requiring all people over retirement age to shove £20,000 in the kitty, so that the 20 per cent whose care costs £1,000 or less can subsidise the 20 per cent whose care costs £50,000 or more, seems actually to grasp the nettle.

Needless to say, this proposal is the one that has caused outrage, with even The Independent describing how people could be "forced" to pay this money. Yet, if you look at the average cost of care – about £31,000 – it's a bargain, especially when payment options are quite flexible and generous. This is the suggestion that really needs to be examined and debated, because it is a real opportunity for us to look at the sort of society we are and the sort of society we want to be.

Clearly we do not, generally, wish to feel that the care of elderly relatives is our own responsibility. We are not alone in this. In France, where social care is actually funded through the health service, there is a legal obligation that stipulates that adult offspring are required to look after elderly parents who do not have the means to look after themselves.

After the heatwave that killed 15,000 mostly elderly people a few years back, the law was actually tightened to confer an obligation to keep in touch with elderly parents, rather that just set up a standing order. This legislation was brought in after so many died without their families even discovering the fact for weeks on end.

I think this is a pretty appalling testament to how the "breakdown of the family" across Europe is not just a question of how children are brought up, but how we all care for each other. Perhaps it would be good for all of us if we brought social care away from the margins of our society, and into the centre.

The compulsory insurance scheme has been called "the comprehensive model". But perhaps it is not quite comprehensive enough. This idea needs to be embraced and, in fact, needs to be extended. Many campaigning groups have leapt at the opportunity to remind us that not only the elderly need social care. Some families need social care for a lifetime if they have family members who are born with disabilities.

Others find that an accident or an illness provokes a need for social care that no one was prepared for, sometimes for a short period, sometimes for the rest of a lifetime. Maternity or paternity leave is actually social care as well, even though we tend not to see it that way.

In the short term a lump sum upon retirement makes sense. But perhaps it is worth examining the idea that all social care should be financed under a national insurance scheme, one that we can make claims on at various times in our lives for various members of our families. The social structure whereby we look out for each other is no longer sustainable. Maybe this is our opportunity to shore it up, so that we all look after each other.

React Now

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

Recruitment Genius: In House Counsel - Contracts

Negotiable: Recruitment Genius: This leading supplier of compliance software a...

Recruitment Genius: Associate System Engineer

£24000 - £30000 per annum: Recruitment Genius: The Associate System Engineer r...

Recruitment Genius: Executive Assistant

Negotiable: Recruitment Genius: An Executive Assistant is required to join a l...

Ashdown Group: Marketing Manager - B2B, Corporate - City, London

£45000 - £50000 per annum + benefits : Ashdown Group: A highly successful, glo...

Day In a Page

Read Next
Zoe Sugg, aka Zoella, with her boyfriend, fellow vlogger Alfie Deyes  

If children are obese then blame food manufacturers, not Zoella

Jane Merrick
Amos Yee arrives with his father at the State courts in Singapore on March 31  

Singapore's arrest of a 16-year-old YouTuber is all you need to know about Lee Kuan Yew's legacy

Noah Sin
General Election 2015: The masterminds behind the scenes

The masterminds behind the election

How do you get your party leader to embrace a message and then stick to it? By employing these people
Machine Gun America: The amusement park where teenagers go to shoot a huge range of automatic weapons

Machine Gun America

The amusement park where teenagers go to shoot a huge range of automatic weapons
The ethics of pet food: Why are we are so selective in how we show animals our love?

The ethics of pet food

Why are we are so selective in how we show animals our love?
How Tansy Davies turned 9/11 into her opera 'Between Worlds'

How a composer turned 9/11 into her opera 'Between Worlds'

Tansy Davies makes her operatic debut with a work about the attack on the Twin Towers. Despite the topic, she says it is a life-affirming piece
11 best bedside tables

11 best bedside tables

It could be the first thing you see in the morning, so make it work for you. We find night stands, tables and cabinets to wake up to
Italy vs England player ratings: Did Andros Townsend's goal see him beat Harry Kane and Wayne Rooney to top marks?

Italy vs England player ratings

Did Townsend's goal see him beat Kane and Rooney to top marks?
Danny Higginbotham: An underdog's tale of making the most of it

An underdog's tale of making the most of it

Danny Higginbotham on being let go by Manchester United, annoying Gordon Strachan, utilising his talents to the full at Stoke and plunging into the world of analysis
Audley Harrison's abusers forget the debt he's due, but Errol Christie will always remember what he owes the police

Steve Bunce: Inside Boxing

Audley Harrison's abusers forget the debt he's due, but Errol Christie will always remember what he owes the police
No postcode? No vote

Floating voters

How living on a houseboat meant I didn't officially 'exist'
Louis Theroux's affable Englishman routine begins to wear thin

By Reason of Insanity

Louis Theroux's affable Englishman routine begins to wear thin
Power dressing is back – but no shoulderpads!

Power dressing is back

But banish all thoughts of Eighties shoulderpads
Spanish stone-age cave paintings 'under threat' after being re-opened to the public

Spanish stone-age cave paintings in Altamira 'under threat'

Caves were re-opened to the public
'I was the bookies’ favourite to be first to leave the Cabinet'

Vince Cable interview

'I was the bookies’ favourite to be first to leave the Cabinet'
Election 2015: How many of the Government's coalition agreement promises have been kept?

Promises, promises

But how many coalition agreement pledges have been kept?
The Gaza fisherman who built his own reef - and was shot dead there by an Israeli gunboat

The death of a Gaza fisherman

He built his own reef, and was fatally shot there by an Israeli gunboat