Risk Register: The 'Behan report' could solve the social care riddle

Sir David Behan is stepping down from the Care Quality Commission amid widespread praise and respect from leaders across the health and social care system.

In a statement on Monday, Sir David said: “I now feel it’s time to move on, to make a contribution in a different way.”

But move on to where?

He wants to hand over the CEO reins by the summer to give the CQC enough time to find a suitable replacement.

This summer is also when the much delayed social care green paper is due to finally be published, which Sir David is already confirmed to be working on as an expert contributor. Is his timing just a coincidence?

It isn’t too much of a stretch to imagine him stepping up to the mark and heading a major government review of how to solve the social care crisis, which has been blamed for much of this winter’s pressure on the NHS.

He has plenty of credentials for such a role.

He has first hand experience of social care as, long before he was knighted, Sir David started his career there. From 1994 to 2003, he served as a director of social care for various bodies. He then presided over the Association of Directors of Adult Social Services, and worked for the Department of Health as director general of social care, local government and care partnerships, before joining the CQC in 2012.

At the regulator, Sir David has been praised for transforming the organisation from its troubled past, which was so tangibly exposed by the Mid Staffordshire scandal.

Then there is his political experience. The disaster of the last Conservative manifesto and its “dementia tax” shows you need political acumen to navigate the thorny issue of how to fund social care.

As CQC chief, Sir David has shown the ability to straddle controversial issues without having major disagreements, at least publicly, with the health secretary or other national leaders.

But neither has he shied away from saying what needs to be said, as the last two CQC State of Care reports show. Presented before Parliament, the 2016 report declared that social care was “approaching a tipping point” where there would be a significant increase in people whose needs were not being met. Last year, he said the NHS was operating under the “toughest climate that most can remember”.

He is someone who, when needed, can choose the moment to drive home uncomfortable truths.

Tellingly, he also used the 2017 publication of the State of Care report to say: “The future of the social care system is one of the greatest unresolved public policy issues of our time – a long term sustainable solution is urgently required.”

When Sir David says he is looking to make a new contribution, what better than resolving the difficult and complex challenge of social care?

In 30 years, we could still be referencing the landmark “Behan report” that finally answered the riddle of social care, which eluded many in government for far too long.