Labour’s election winning manifesto of 2024 included a commitment to solve the Adult Social Care (ASC) crisis. With a big majority, we might have expected decisive action based around a clearly though through plan. Instead we got yet another review, The Casey Commission, to be delivered in 2028 just in time for the next election!

That was early confirmation that after fourteen years in opposition, Labour had done no serious thinking about a really important issue. So fair play; hats off to Andy Burnham for confronting this problem head on in his first week in office. It takes some political courage to front up to an apparently insoluble problem.

Patrick Loxdale
RIGHT FIELD (Cambrian News)

It’s worth remembering that Social Care is a devolved issue, so Wales won’t necessarily follow England. But any tax changes that are implemented to fund this are likely to apply across the whole UK, and “Barnett consequential” money will come to us. One would like to think that a PM committed to Devolution, would include all four nations in the discussions and decisions.

So, can “Our Andy” fix it? A number of things worry me.

Firstly, he is repeating the mistake a lot of politicians make in blaming all of the NHS’s problems on a failing ASC system. There is no doubt that the two are related, but the NHS’s issues are multifactorial. In other words we won’t fix ASC and wake up the next morning to a brilliant functioning NHS with no corridor care and no waiting lists. Life’s not that simple.

Secondly, he is in danger of falling into a trap of his own making. If we see healthcare and social care as all part of the same spectrum, we will probably manage and regulate ASC in the same way as the NHS. The danger is that we overregulate and drive the cost through the roof. Remember that the vast majority of ASC is provided informally, in people’s homes often by family; it isn’t regulated and probably doesn’t need to be.

Thirdly the costs involved. Figures being bandied about suggest that ASC can be “solved” with an extra £18 Billion or so. One suggestion for raising this is a flat rate 10 per cent levy on everyone’s estate at death. That’s likely to be difficult to administer and prove a nightmare for grieving families. In 2010 it was dubbed “The Death Tax” and helped Labour lose the election.

Another suggestion is a 1.8 per cent levy on all workers over 34 and earning more than £6240 pa, put in to an investment fund, to provide for their care later in life. Differentiating that from an increase in Income Tax or NI is surely dancing on a pin!

Regardless of how this money is raised, will it be enough? Back in 2023, this paper reported £57 Billion of unfunded social care. That figure is almost certainly an underestimate. An AI trawl suggests there is £10 Billion of unpaid/unfunded care in Wales alone, with an England and Wales figure of circa £170 Billion.

Providing social care for a relative may be fulfilling but it is also tough. If we are all to pay more tax to fund a National Care Service, then inevitably the expectation and demands on such a service will expand, dramatically. Taxes change our approach to life. The copers may elect to stop coping. If so, that £18 Billion isn’t going to touch the sides.

Finally, do we have the human resources? With a million 16-24 year old NEETS, the answer is of course yes, but is there the political will to make them go to work? It’s not certain that backbench Labour MPs will agree to that.

Just possibly the PM will work some alchemy and we will have a brilliant National Care Service by 2030. If not, we need at very least to explore other solutions.