A shortage of resources and a shortage of risk-pooling has meant that the long-term care of older people has suffered from a political and governance failures. James Lloyd, argues that political scientists need to direct their attention towards social care, with more concerted, detailed studies which will provide evidence to address policy problems.
Few, if any, policy areas have as been neglected by political scientists as social care funding, despite a long-running policy debate on how to fund the long-term care of older people in England, which most recently gained some prominence with the final report of the Dilnot Commission on Funding of Care and Support in July.
The ‘problem’ of long-term care funding in England is actually several problems. Public funding of care, allocated via local authority spending decisions, is under-resourced and excessively rationed, particularly as demand rises with population ageing. The protection against catastrophic care costs provided by the state is limited, and there is no private sector insurance market to speak of, so families routinely confront enormous accumulated bills for care. Unmet need, a ‘postcode lottery’ in support and over-reliance on ‘informal’ family carers is also widespread.
Put simply – a shortage of resources and a shortage of risk-pooling. However, this longstanding sore of a policy problem is ultimately preventable and unnecessary. The state and wider society – and the older population in particular – have sufficient wealth to ensure the best funded social care system in the world. Ultimately, this problem does not arise from money and resources, and there is no social care ‘funding’ problem. The ‘care conundrum’ referred to in the title of a paper, Politics and the Care Conundrum, recently published by the Strategic Society Centre references the fact that these desperate problems continue despite the resources potentially available from public and private sources.
In other words, this is a political or governance failure on a massive scale, with consequences for the welfare of hundreds of thousands of people. So, in our report, drawing on my own limited education in political science, we gingerly set out to borrow ideas and insights from various theories of political science to understand this ‘care conundrum’.
This paper is an attempt to crack open this long-running policy problem using the insights of political science. Interest group theory, political psychology, agenda-setting theory, institutionalism – we threw all of these in, and more.
And what did we find? Multiple, compelling, potential explanations of the social care funding problem in England. For example:
- Ignorance of what social care is among the public and media;
- A confusing, complex, illogical mess of institutions developing social care policy;
- Potential turf wars between Whitehall departments, and between local and central government.
We seek to advance the long-term care funding debate by using the analysis to propose some potential ‘fixes’ to these issues as the basis for a sustainable reform to social care funding that can maintain across multiple political and economic cycles. We propose an institutional ‘fix’ – an Office for Care and Living – building in many ways on the precedent of the Office for Budget Responsibility.
But for political scientists, the paper is really an attempt to wave a red flag and direct their attention to a contemporary problem of politics and policy that is in desperate need of detailed, concerted study. We could find nothing on social care funding in any of the major British political science journals unlike – say – Europe, immigration and devolution.
We aim to show the potential for political scientists to elucidate this area, and there must surely be multiple PhD theses, journal articles and books waiting to be written on this topic. Undoubtedly, social care and the social care system are complex topics, and a fairly sizable amount of ‘baseline knowledge’ is required before being able to look these through the lens of political science. However, there are excellent academic departments – SPRU and PSSRU particularly – where such knowledge is concentrated and available.
But we are not just flagging the topic of social care funding to the political science academy for collective intellectual reward. As Politics and the Care Conundrum argues, long-term care funding is an important, pressing contemporary policy problem affecting thousands, and it needs the help of political scientists in devising the basis for a long-term solution. The tireless efforts of campaigners for reform will ultimately be ineffective if changes provide only temporary fillips, because the underlying structural causes of the ‘care conundrum’ have not been addressed. Political scientists can help do this.
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