I listened to two items on the radio this morning. The first was an interview with Sir Andrew Dilnot and the second was a reading from Henry Marsh’s Admissions. And I can keep quiet no longer.
Sir Andrew Dilnot, economist and the country’s leading expert on social care (You may remember his authoritative and widely welcomed report on the subject, which broadly recommended a national insurance scheme to take away the fear of the cost of care in old age - https://mydonkeybody.blogspot.co.uk/2011/07/medical-day.html), was commenting on the imminent Conservative manifesto proposals concerning funding for the elderly. You can hear the interview here - Today programme, at 1 hour, 10 min in. He was measured and he was scathing in his assessment.
According to a newspaper account, ‘Theresa May’s social care package fails "to tackle the biggest problem” facing elderly people, the man who carried out the coalition’s review into service in England has said.
‘On the election campaign trail the PM had said politicians could no longer “duck the issue” and that the Government had been “working on a long-term solution” for the needs of an ageing population.
But Sir Andrew said he was “very surprised” by the new thinking from Downing Street. “New thinking that I’d argue shows a less than full understanding of the problems when there is a green paper that is due to come out later this year,” he added.
‘Speaking on BBC’s Radio 4 Today programme, Mr Dilnot, who is also a former head of the UK Statistics Authority, said: “The disappointment about these proposals that we’re expecting to hear in the Conservative manifesto later is that they fail to tackle what I’d argue is the biggest problem of all in social care, which is at the moment people facing a position of no control.
“There is nothing you can do to protect yourself against care costs; you can’t insure because the private sector won’t insure it and by refusing to implement a cap. The Conservatives are now saying that they are not going to provide social insurance for it, so people will be left helpless knowing that what will happen is that if they are unlucky enough to suffer the need for care costs they will be entirely on their own until they are on their last £100,000.
"The analogy is a bit like saying to somebody you can't insure your house against burning down. If it does burn down then you're completely on your own; you have to pay for all of it until you're down to the last £100,000 of all your assets and income," he said.’
Someone whose political views are unusually well-informed and reliable messaged me this morning. “Cruel, cruel Conservatives! Sir Andrew D very good on it on Today. Cost needs to be socialised not put on individuals like this."
And he’s right. It’s not just social care which is at risk. Henry Marsh is an eminent neurosurgeon. His book, Admissions – a life in brain surgery, was published a fortnight ago. He retired from the NHS in 2015. In today’s reading he recounted a day’s operating list, of whom the fourth was a lady with diabetes. It revealed the unsustainable pressure that “efficiency” and “targets” have increasingly imposed on the service. The result for one patient was fatal, and for one operating team clearly traumatic. The episode ended with him breaking the news to the family:
‘… I wanted to scream to high heaven that it was not my fault that her blood sugar level had not been checked upon admission, that none of the junior doctors had checked her over, that the anaesthetists had not realised this. It was not my fault that we were bringing patients into the hospital in such a hurry that they were not being properly assessed. I thought of the army of managers who ran the hospital and their political masters who were no less responsible than I was and who would all be sleeping comfortably in their beds tonight, perhaps dreaming of government targets and away days in country house hotels and who rarely if ever had to talk to patients or their relatives. Why should I have to shoulder the responsibility for the whole damn hospital like this when I had so little say in how it is run? Why should I have to apologise? Was it my fault that the ship was sinking? But I kept these thoughts to myself and told them how utterly sorry I was that she was going to die and that I had failed to save her. They listened to me in silence, fighting back their tears. “Thank you, doctor,” one of them said to me, eventually.’
It happened last night that a group of us were enjoying each other’s company in my favourite coffee shop, the Cornerstone Café in Grove. We were talking about the questions we’d like to put to candidates in our local hustings on 1st June, and I found myself concluding that Labour was more likely to provide adequately both for health and social care – and more surprisingly that their financial plans were not as daft as the corporate media would have us believe. Nationalising utilities does not increase national debt, in that they become national assets, like a house (or recovering the family silver). Borrowing for investment when interest rates are at an all-time low makes good sense. Raising tax revenues from corporations and the wealthiest 5% in society doesn’t wholly work only if those firms and individuals decide they don’t want to contribute to the common good and set about avoiding or evading their share. Sir Andrew’s comment about the social care proposals is relevant. 'Mr Dilnot said he was “very disappointed” by the proposals in the manifesto. “Not personally. I feel very disappointed for all of us – the millions of people who are very, very anxious about this,” he added.'
I guess that’s what all of us have to decide, captains of industry, the comfortably off, those with no jobs and those who depend on benefits and food banks - and everyone in between. Will we care about the millions or will we care just about ourselves? It’s all too easy to think, “I’m all right, Jack. The rest can go hang.” The issues are really too important to be reduced to schoolyard name-calling and character assassination.