Social care is a ticking time bomb in Britain – why don’t any of the main parties have a plan to tackle it? | Gaby Hinsliff

In a church hall in suburban Croydon, south London, a familiar Beatles medley plays. The crowd sways and sings, and an 80-year-old woman reaches out to take her husband’s hand.

Paul has vascular dementia and can no longer speak, but from time to time he smiles as if he recognizes him. His wife, Jill, says they were sent home after their diagnosis with nothing more than an information leaflet and the feeling that they were on their own as there is not much the NHS can offer. A caseworker comes for half an hour twice a week, but other than that, Jill looks after Paul while she waits for the heart operation herself and worries about what they will do when she has the operation. He was recently hospitalized with an infection and she found him “trying to get out of bed by himself because he doesn’t know how to use the doorbell and he was terrified.” But at least this Singing for the Brain therapeutic group, organized by the Alzheimer’s Society for people with dementia and their carers, is a weekly opportunity to get out of the house and be with people who understand.

“It’s about friendship really,” says Peter Edwards, the leader of the group funded by Merton council to lead today’s song. He has cast Elvis, Queen, Carole King and many Beatles; whatever makes them young again, to their lives spread out before them, dancing with their lovers. The volunteers who distribute the tea are always friendly and an air of extraordinary tenderness permeates the room.

Care is, as Liberal Democrat leader Ed Davey said in a moving election broadcast about caring for his severely disabled son, the story of millions. It is the story of Keir Starmer, whose mother suffered painfully from a form of arthritis, and it was also the story of David Cameron during the six tragic short years he survived his son Ivan.

These intimate experiences have deeply affected all three men and yet somehow Cameron still led a coalition (of which Davey was part) that cut the budgets of councils providing social care, while Starmer is yet to announce comprehensive plans to solve it.

Along with the rise of AI or the threat of Russia, dementia is one of the hidden forces reshaping the British political landscape. Almost two-thirds of council funding already goes solely to social care for seriously ill adults and children, painfully reducing other priorities. But by 2040, the number of Britons living with dementia is predicted to increase by around 40%, from 982,000 people to 1.4 million. Even now we don’t have enough beds or staff in nursing homes, but we will need many more. Meanwhile, the costs to the state are dwarfed by the cost to the sick themselves, depleting life savings to pay for the nursing care that if they had cancer they would receive for free, and for families who are left paying the bills. . The care economy seems hopelessly failing, and yet there is a bright spot on the horizon.

Two new drugs that have been shown to slow the progression of Alzheimer’s (although unfortunately not other common forms of dementia) are pending approval by medical regulators. Lecanemab and donanemab are not cures, but they could prolong the most horrible stages of dementia into a future that many elderly patients will not reach, stopping them at the point where a good life is still available to be lived and thus dramatically reducing the pressure on the attention. Add to that a massive public health campaign teaching young Britons that tackling diet, exercise and smoking can help prevent some cases of dementia, and all is not lost.

The downside, says Alzheimer’s Society associate director of advocacy and system change Mark MacDonald, is that only people accurately diagnosed by a PET scan or lumbar puncture are eligible for the new drugs. Since the NHS does not have enough scanners, at the moment it is around 2% of them. Hence the charity’s call in this election is for better diagnosis and treatment and more training for healthcare workers, not for bigger reforms that the big parties don’t want to talk about.

When Theresa May tried it in 2017, the Labor Party coined the lethal term “dementia tax” for its manifest plans to make people with assets of more than £100,000 pay for home care. But the Conservatives did much the same to Andy Burnham in 2010, calling his call to fund social care through an inheritance tax a “death tax”. The issue, endlessly weaponized but never resolved, now sits ominously in the Labor Party’s inbox. Although the apparently outgoing government originally promised to cap lifetime care bills at £86,000 and If we let most people keep the first £100,000 of their assets, two years ago Jeremy Hunt shunted that expensive promise to 2025, effectively making it someone else’s problem.

There is a logic to financing healthcare by tapping into the housing wealth collectively accumulated by baby boomers. However, putting everything on individuals who are unlucky enough to have dementia (the opposite of the risk pooling that the NHS achieves for other diseases) turns aging into a terrible lottery. Ask Croydon carers what they want from the incoming government and the topic quickly arises.

Sharon’s partner Andrew, an ambulance worker whose memory began to fail when he was 50, died last year, but the friends she made in the singing group still draw her back here. Growing up poor in the East End, she herself worked in a council nursing home and worked two cleaning jobs to climb the housing ladder. Now she herself is disabled and she fears the consequences for her family if she ends up needing care. Her friend Ruth is also afraid of losing the house if in the future she cannot cope with the needs of her husband Tony; Her eldest son lives with them because she cannot afford to buy property. “It seems unfair when you’ve worked all your life.”

Dig deeper, however, and much of what the Croydon group wants is heartbreakingly modest: better pay for care workers, help navigating the bureaucratic maze that obscures any help they are entitled to, more opportunities like this to meet other people in the same situation. An hour of singing to the Beatles seems like a small thing, easy to eliminate for any city council on the verge of bankruptcy. But it’s one of the ways people cling to half-remembered ghosts of happiness.

Leave a Comment