The Conservative manifesto made a big gamble on its social care policy – the downside could be that the insurance industry will make it a losing bet, writes Jenny Ousbey
I bet Theresa May would make a mean poker player. When she retires from politics I reckon she could make a tidy living amongst the bright lights of Vegas – outwitting drunk tourists with her sleight of hand.
No-one expected the prime minister to reveal such a bold social care policy, just days after newspapers were reporting (and therefore had been briefed) on a likely manifesto commitment of an £85,000 cap. In reality what the Conservatives are proposing is vastly different, in principle and in effect.
In a former life I was adviser to the minister with responsibility for social care, during the days of the Coalition government where the Dilnot proposals were the only game in town. Dilnot very nearly became a reality, but political differences, and a lack of political bravery meant these reforms were kicked into the long grass.
Much of those behind-the-scenes meetings I was party to at that time, in warm airless rooms, occupied by bright but jaded civil servants tasked to draw up increasingly complex formulas, will have been played out in fast forward over the past few months.
The policy being proposed in the Conservative manifesto will delight and/or hoodwink many. Some will agree with May’s pitch that it is a sign she is willing to tackle one of the biggest challenges facing the UK today.
Others, including Andrew Dilnot himself, are disappointed the Conservatives have ducked the ‘uncertainty’ issue which plagues people – namely, how much they’ll end up paying for care. As while the £100,000 ‘protection’ of people’s assets provides some certainty, the lack of a cap means some people’s risk of incurring catastrophic care costs, won’t be shared amongst the many.
At the heart of these proposals (and indeed any social care funding reforms) is one of communications and understanding. Or rather, a lack of. There is still deep misunderstanding amongst the public as to who pays for social care. And there is even less knowledge around the current difference in how assets are taken into account if you are in residential care, compared to receiving homecare.
Post-election the Conservatives, local authorities, social care providers and the broader health sector will need to work together to communicate clearly and simply the impact of such a policy. This requires a degree of honesty with those who will now have to pay. But it’s also an opportunity to develop a positive narrative around in investing in dementia, telecare and carers to name a few.
Difference in quality
For companies operating in the social care sector, if enacted (and this is going to take legislation and consultation), the Conservative pledge will provide some certainty in terms of business planning. But of course, the devil is in the detail.
You could argue the policy would be a boost to providers of premium home care services, as more will be pushed into the self-pay market. But that depends on what rules will be created around how quickly people can run down their assets. Indeed, if people are more willing to pay for premium services, it will make the difference in quality even starker when they get to the point where the state must step in.
What is also not yet clear, is how any of this is going to help local authorities plug the c£2.8bn social care funding gap, and therefore the squeeze on staffing and regulatory costs that plagues many providers.
Five years ago, institutional inertia at the Treasury blocked progress on tackling this challenge. Time is still running out for the insurance industry to cough up the products that people will need to feel secure. Perhaps May’s policy will ‘call cold’ the industry to reveal its hand. One must only hope that her bet doesn’t result in a fold.
Jenny Ousbey is director and head of health at WA Comms