Many things will get written in the annals of history about the 2017 General Election but it’s almost certain social care will receive a fair share of historians’ attention.
If the election is anything to go by, a huge issue that continues to cause almost universal astonishment and uncertainty is the cost of care in later life and how the system will be improved to help spread these costs more fairly.
But one positive thing to take away from what at times was a polarised debate is that care and support for older people is a mainstream political issue, now more than ever.
Half of those surveyed by Ipsos Mori and the Health Foundation believe care will get worse over the coming year. And more politicians now recognise that when they propose changes to social care, they need to take public opinion with them.
In truth, the debate that took place, for example about the so-called ‘dementia tax’, only skimmed the surface. There are multiple problems across health and social care and we set many of these out in our new report, The obstacle course: overcoming the barriers to a better later life.
What we hear from older people
In 2016, over 1 million people accessed support from us. We heard about some of the repeat and for some, intractable, problems that many people face.
Our report particularly focuses on the issues we hear about through our Helpline, where we give free and confidential advice. Concerns about paying for care got raised with us – the main health and care issue we addressed through our Helpline over the past 12 months in fact.
However, we also heard about the many other barriers older people, their families and carers can experience, in terms of receiving assessments and qualifying for care. Often, further obstacles prevent people getting basic aids and adaptations to maintain independence, as well as up after-care, such as NHS Continuing Healthcare, following a stay in hospital.
When the UK really ought to be very well advanced in preparing for rapid population ageing, instead we hear the battles people have to endure in a health and care ‘system’ that can feel unresponsive and unsympathetic to their concerns.
Older people and their loved ones and friends often come to us at a time of crisis but they scarcely believe the bureaucracy involved and the hurdles they have to jump to get even the most basic support.
In our new report we set out how we heard from Carol in the North East who faced an agonising wait to see her dad secure a bed in a nursing home with specialist support for people with dementia.
We also heard from another Carol, who lives in the South East, who was angered at what she saw as the wrangling between health and social care services as her mother’s health deteriorated and a wait for physiotherapy went on for six weeks.
Another shocking case was Richard’s. He was left without the wheelchair he needed following an amputation and a partial hip replacement. With no toilet or bathroom downstairs, and without the care he hoped to receive, he ended up having to wash in his kitchen.
Time and time again, the people we hear from tell us something fundamental has gone wrong with the way health and care services are set up. They remain fragmented and beset by complex qualifying criteria and rules, worthy perhaps of a Kafka novel but not at all equipped to meet the needs of older people in 21st century Britain. Typical quotes included in The obstacle course can only hint at people’s deep sense of frustration:
“These people [care workers] are under enormous stress, working long hours and overstretched. I am not angry with anyone – it’s the system that needs to change”.
“The lack of resources needs to be addressed urgently. A lot of elderly people don’t want to face the future.”
Many challenges ahead
Returning to politics, what was also concerning about the election was the impression that, besides health and care issues, there’s little of real substance to debate in terms of what needs to change for older people. But we know that on incomes and living standards, too, there’s a long way to go before we can truly say we have tackled all the disadvantages older people face.
1.9 million older people – as many as 1 in 6 pensioners – still live in poverty.
And £3.5bn in vital benefits for older people goes unclaimed by each year.
Thinking just about Pension Credit, 1.4 million pensioners still don’t claim it but it is a key benefit to top up low income. This can amount to £2,000 a year which goes unclaimed by the poorest pensioners. This is money sitting in Treasury coffers that really needs to be in pensioners’ own pockets, paying for fuel, food and other important finances.
But as the dust settles and a new parliament starts to set new priorities we believe it’s time for politicians to think afresh about the challenges facing our ageing population.
Last week the Prime Minister said we face critical challenges and now is the time to be bold in confronting them. We agree. Her government can start by taking the necessary action to get the UK ready for the doubling in the number of over-85s, now just over a decade away. The inescapable conclusion we have drawn from the enquiries we received in 2016 and now summarised in The obstacle course, is that we all have a great deal to do to get prepared.