As a former adviser on social care reform to a Conservative prime minister, allow me to explain why Andy Burnham’s proposals on the issue – which I don’t know about, since he hasn’t revealed them – are wrong. Hints have been dropped, and a speech is planned for Wednesday.
Burnham is committing himself to tackling the problem that brought David Cameron to my ward at the John Radcliffe Hospital in Oxford. He came in response to concern from a Witney constituent about delayed discharges. As ever, more than half my ward was occupied by patients termed ‘medically fit for discharge’. They were in hospital beds because the queue for carers at home, or for a care home bed or other supported accommodation, was long.
Most of my patients are the frail elderly, so I work on wards that see more of these delays than most. Across acute hospitals in England, roughly one bed in nine is occupied by someone with no medical need to be there but who cannot be immediately discharged elsewhere. Back when Cameron visited, the figure was about one in 40.
Making social care free would not make it abundant
Social care was seen as a terrible problem even in those sunnier years. Gordon Brown had appointed Burnham as Secretary of State for Health. His proposals were bold. He set out a vision for a National Care Service (NCS) much like the NHS, with personal care free at point of delivery for all. One of the proposed funding mechanisms was gleefully seized upon by his opponents as an additional death tax. In the general election that soon followed, Labour lost.
