Labor had plenty of time to think about social care. Now it has a chance to | Sonia Sodha

PDuring the elections, politicians from different parties offer their ideas, citizens vote for their preferred option and a government is formed. That’s how democracy is supposed to work. Sometimes it feels as if the British political system has never been so far from this ideal.

From the Conservatives we have had years of populism: the dishonest idea that Brexit was somehow the answer to all the long-standing structural challenges facing Britain. It accomplished nothing and they were punished accordingly. The Labor Party, by contrast, ran an election campaign designed to translate widespread dissatisfaction with the Conservatives into maximum votes, saying very little about what they would do about the pressing problems they would face in government. It has worked, but it has left them paralyzed when it comes to the difficult choices facing a country that is no longer a global economic powerhouse and that is facing the budget realities of an aging population and a declining birth rate.

There is no clearer sign of this than what is happening to social care, a system that has been in crisis for more than a decade. The case has long been clear: as Britain ages, demand for adult care continues to increase. But unlike NHS services, many people have to bear the cost of the care they need as a result of diseases such as dementia; the state will support those who need care, but only if they have a low income and have assets less than £23,350. That state aid is significantly underfunded, meaning more and more people are left to go it alone without the care they need, even if they meet the financial test: Age UK estimates 2.6 million people over 50 years old do not have access to the support they need to go to the toilet, eat and wash. Local governments pay so little for nursing home placements that private payers end up paying for them cross-subsidization of state-funded careand being a good caregiver requires high skills, yet offers low pay. The human costs are terrible: people are denied basic dignities and end up in hospital because they have nowhere else to survive. The implications for a struggling NHS are profound.

We are in this miserable position because politicians have failed to control the nettle for three decades: it was in 1999 that a royal commission recommended that personal care should be provided on the same basis as health care at the NS. Since then, numerous green papers, white papers and independent reviews on social care have been published – including the 2014 Barker Commission, which came to a similar conclusion to the royal commission. But reforms have never been implemented because while there is consensus that we don’t spend enough on social care, the question of who should pay for it is politically too difficult.

Keir Starmer’s approach was to be vague about social care in the US Labor Manifesto. And last week, Health Secretary Wes Streeting announced that cross-bench peer Louise Casey would chair yet another independent social care commission, due to report in 2028. She will be tasked with building a cross-party consensus on a new model.

Casey is a wise hire from Streeting: a fearless operator used to knocking heads together and forcing people to face hard truths. But she was given the wrong assignment. The biggest decision that urgently needs to be made about social care – how to fund it – is a political choice. Currently, healthcare costs are highly individualized: if you are unlucky enough to develop dementia, people have to bear the sometimes extremely high costs of that care themselves until their assets are used up.

The choice facing Labor is: how far should it be collectivized? Should they opt for a more universal NHS-like system in which everyone who needs care later in life receives state support? Or the workaround of the kind of capped cost model the Conservatives were considering, where people with assets have to bear the cost of care themselves, but until they have around £100,000 rather than Still £20,000 leftand where the state will ultimately intervene, but only after you have paid for a significant part of the care yourself? How should more state aid be financed?

The best moment for Starmer to make his position was in opposition. But to be honest, the lesson of the past decades is that every politician who participates in elections and offers a solution is chosen by the other party. The second best moment is now: when you lead a new government with a large majority. Starmer should not have asked Casey to head a committee, but given her a brief on what he wants the system to look like and put her in charge of implementing it.

Instead, we must believe that some kind of consensus between the parties will be reached by 2028, presumably in the hope that the parties will go into the next election with the same idea behind them, despite their differences in political values. This won’t happen in a million years. It’s about a misunderstanding of what politics is for and how consensus, where we see it, is usually achieved: not by making it up in advance, but by doing something that future governments of other colors will find to be the don’t want to unravel choice.

The Conservatives may have endorsed the vague principle of an NHS after the Second World War, but they fought Labor tooth and nail on what was needed to create this: putting hospitals into public hands to create a uniform health service. free upon delivery. There is a similar post-war story about social housing: the Conservatives were initially reluctant to endorse Clement Attlee’s plans. public housing program.

Yes, there are risks. Yes, Starmer faces tougher circumstances than Tony Blair, the last Labor prime minister to win a major victory. Yes, asking taxpayers to contribute more to a collectivized system could erode Labor’s majority at the next election or even cost them altogether.

But doing nothing is not without risk, as voters are increasingly noticing losing confidence in politics to achieve results. Politicians who try to outsource politics will not help. And ultimately, there’s a bigger question at stake here: If you’re not going to spend the political capital tackling the big challenges the country faces, using the social democratic principles you hold dear, what good does it have? point in winning elections at all? ?

Sonia Sodha is an Observer columnist