Here's a coincidence. Last Friday, official figures revealed an estimated underspend of £1.7bn on the NHS budget in 2011/12. Tomorrow, we will get the depressing but unsurprising confirmation that the Treasury has successfully blocked the Dilnot commission's plans for reform of long-term care in England that would have cost an initial £1.7bn.
We should, I suppose, be grateful that we are at last to get sight of the care and support white paper and the draft bill intended to enact it, even if the "progress report" on funding reform that is to appear alongside the other documents will do little to live up to its title. There has been, it is now clear, scarcely any progress since the Dilnot plans were tabled exactly a year and a week ago.
It is true that the white paper is hugely important in its own right. The legal reform it will propose would drag the statutory framework for support of older and disabled people out of the poor-law dark ages, representing the first fundamental overhaul since 1948. It will aim to clarify that often confusing framework, make choice and control a reality for most people needing support, drive improvement in care quality and signal a shift in the focus of the system to keeping people well and promoting wellbeing.
To further these ambitions, there will be key announcements: a fresh approach to information and advice for families, new rights for carers, a minimum level of care, "portable" needs assessments so people may move without having to be reviewed, extra funding for supported housing and trials of free care at home for people with terminal illness.
These are to be welcomed, but they are side dishes to a main course that is stuck in the kitchen. Failure to convince the Treasury that the crisis in social care funding is such that it demands action now, not some time after the next government spending review, means there is no prospect of an end to the anxiety facing millions of older people and their families. They will find little consolation in any warm words from ministers about endorsing the Dilnot principles.
Who is to blame? Former Labour health minister Lord Warner, a Dilnot commissioner, has been worrying publicly that he and his colleagues should have played a cannier game: setting the recommended cap on individual liability for care costs at £50,000 or £60,000, rather than the £35,000 they plumped for, would have given the Treasury less wriggle room. Certainly the cap accounts for almost all the cost of the plans, whereas the big proposed rise in the threshold for liability – from the present £23,250 of assets to £100,000 – would add only another £100m.
Alternatively, we might have expected more of all-party talks on funding reform. These, now broken down after ministers said they would deliver their own report tomorrow rather than a joint one, appear to have got almost nowhere. Would they have been more productive held at party-leader level?
In the end it looks as though the Treasury just doesn't get it. Or, if it does, it sees no political dividend in grasping reform. Either way, its intransigence is an indictment of the short-termism of our system of government.
By contrast, a committee of peers last week opened an inquiry into the impact of our ageing population on public services. Chaired by Lord Filkin, the committee has already pinpointed a glaring problem: a 25-year lag in the projections of the Office for Budget Responsibility because, it seems, it is using a lower assumption for migrant numbers than that favoured by the Office for National Statistics.
With such crucial differences in key sources of government intelligence, no wonder the Treasury looks complacent.
Sourced from the Guardian, 10th July 2012.