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Laissez-faire: 21st Century Englands Social Care System

Alan Rosenbach Sector Commentator

A broad translation of this French phrase  ‘laissez faire’ means ‘to let go”.  In England in the 19th  century the laissez faire movement saw the role of the state as a passive arbiter whose only functions were to protect private property and administer justice.  

Laissez faire is the philosophy that operates when it comes to social care in the 21st Century. It is partly driven by political idealogy that the market will sort the challenges and partly because it is in the ‘too hard to do box’ for politicians. In both instances it reflects a lack of great leadership, smart ideas and a strong desire to tackle and sort a problem of our era.

What we have had instead since 1997, is 12 white or green papers from the government and 4 independent reviews. (See Richard Humphries from the Kings Fund on Google for the detail).

If you want to know how not to get things done to deliver a system that meets needs in the 21st century this is a great example. Simply keep producing coloured papers and reviews and then don’t make a decision.

Of course all this obfuscation is happening when the economics of health and care are catastrophic. Local government has had an average budget cut of 26% since 2010. Some areas are more badly affected such as those councils serving poorer communities.

It would be all too easy to think that the failure of the state through our politicians to deal with these challenges only impacts on our ageing population. It does impact on the ageing population but many older adults are able to meet the costs of their care. These can be wholly met or partially met through top up payments.

The same situation does not arise for working age adults who have physical disabilities, learning disabilties or mental health needs. For many of these fellow citizens they have a life long financial relationship with the state. Our failure to deal with the funding of care is increasingly letting these people down as services are harder to fund and harder to access.

How best to find a way forward with the way in which we are going to have to fund social care? One answer is not to have yet another green paper which we have been promised for January 2018.

The answers will be found in having a general taxation and insurance funded system for aged care. Working age adults will for the most part need to rely on a state funded system of care and support.

Whether we want to or not, we are going to have to double fund and run a system that takes us from where we are to where we want to get to.  We cannot afford not to do this. Our continued failure to address the issues of how we pay for care is slowly but surely dragging down the NHS which also has financial and work force challenges. These are being made worse by the social care crisis. Our current sytems because they are underfunded do not protect those who are made most vulnerable by their circumstances.

Laissez faire by it’s definition will lead to inequity . Never has there been a stronger case for government to lead the way to offer assurance and security to all of us, whatever our age, that it has the vision and intelligence to provide the right policy for care.  Right now that feels like it is a long way off.






Edel Harris





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