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Funding social care and health care

Updated: Oct 21, 2021

By David Jolley

It is a start. Perhaps begrudgingly I have to be glad that the current Conservative Government has made clear that we need to improve arrangements to fund the care of ill and disabled people.

The need is to recognise the number of people who require help, to accept this and to make fair and appropriate care and treatment available to them. Wishing it away, heads in the sand, has been happening for too long. The victims are the most vulnerable people in our country, and the families who love them and do what they can for them.

Problems are compounded by perverse incentives for money to be wasted when it is soaked up by overly bureaucratic requirements such as those associated with DoLS assessments or sucked into greedy profiteering such as we suspect of some private sector care companies and other providers of facilities in the Covid-19 pandemic.

For many people the urgent requirement is trustable, reliable basic care. Not rocket science itself – the rocket science is in how to attract, train and support good carers and to monitor and rejig the care they are able to provide as needs change over time.

But there is need for more complex interventions when problems become severe and multi-facetted. Thus the creation of a service which reflects the spectrum of needs within the current population, rather than historic boundaries between agencies is what we want. There have been new discoveries, which will save time and money. There are others, which have expense but will reduce adverse symptoms/suffering. Open handed application of what we know should not be impossible, not be painful.

How much and how dispersed are matters to be worked on. We are hardy going to get it right fist thing. We start where we are and improve things some at a time – revise and so on – iteratively. That is how living systems work, survive and grow.

Having accepted we must do something and agreed that we will do something has begged the question of how resources will be redirected to make changes possible. In this the politics of the current government are exposed. Already there is the threat of inventing or aggravating discontent between old and young, rich and poor: increases in National Insurance will take money from relatively poor working age people. They will have little impact on the very rich and most of the benefits will be to current generations, and future generations when they are retired and old. It is a formula for conflict, which calls for quiet clearheaded negotiation to get from where we are to where we ought to be.

At least a start has been made:

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