At HM Treasury, I worked two floors up from Winston.
Under my desk at 1 Horse Guards Road, with the same floorplan – albeit with lower ceilings and thicker walls – sat the Cabinet War Rooms. It’s here that 76 years ago, Churchill walked in and declared “This is the room from which I will direct the war.”
My job as a Treasury minion was about adult social care spending, a very different national challenge to that of the basement’s previous occupants. Funding shortfalls meant public money was being focused on a smaller group of sicker people. We were concerned that if something drastic didn’t happen soon the system would collapse. Talk of social care crisis had been ongoing for some time. We discussed with the Chief Secretary whether they wanted to use their upcoming November statement to act on a recent review into funding options.
This was 2007. Since then, much has changed: the Chief Secretary then was Yvette Cooper; her husband a Cabinet Minister, not a Gangnam Style jiver. Barack Obama still the little-known junior Senator for Illinois. The Milliband brothers still got on. The Brownlee brothers were still at school. Lehman Brothers was still a bank.
But the social care story has proceeded with grim inevitability, basically repeating the nine years prior, but with much less money. A respected white man (Derek Wanless in 2006, Andrew Dilnot in 2011) wrote a clever report which didn’t get implemented, and funding has continued to fall short of what was needed to maintain what had gone before.
"So our debate has become one about whether we can afford not to fix social care. That if we don’t, it might break something we do care about. This should give us pause to thought."
The past twenty years takes on the character of a macabre public policy experiment to see what it would take to lift adult social care up politicians’ to-do list. This experiment has tried scandal: the focus of Panorama this week is abuse in residential care. It’s tried regulation: CQC view a third of adult social care providers as not meeting ‘Good’ standards of safety. It’s tried putting figures to human misery: 1.2m older people don’t receive the social care they need, up 48% since 2010. It’s tried strong lobbying from charities: the situation being branded a ‘disgrace’ by AgeUK and many others.
But here we still are. The latest tactic to be employed is to bring in the NHS. While you may not care that much about the plight of older people with nowhere to go upon leaving hospital, you might if that’s preventing you meeting your A&E target.
So our debate has become one about whether we can afford not to fix social care. That if we don’t, it might break something we do care about. This should give us pause to thought. Not about the ramifications of a broken social care system, but that we seem to be entirely unable to care about public social care – the provision of safe, kind, respectful care to some of the most vulnerable in society – as something of value in its own right.
Are we happy with this? Social care needs someone to walk into a building (the Treasury might be a good place to start) and paraphrase Churchill’s words: “This is the room from which I will sort out this mess.”