My mood darkens every December. Another birthday rolls along too, too fast, bones ache a bit more, the skin feels as thin and fragile as a butterfly’s wing. Mortality shuffles closer, brings quiet terror. But for me, far worse , is fear of infirmity and dependence, a long wait for the end, of being lonely and incontinent in some institution, of becoming a burden on society and my family.
Too many people in the west are now living too long – an unintended consequence of cumulative improvements in medicine and diets. NHS hospital services are under severe pressure as increasing numbers of very old and helpless people are kept on wards because local authorities cannot provide adequate social care. The NHS gets national funding while social care comes out of council budgets which have had budgets slashed mercilessly by first, the coalition government now the Tories. The LibDems, to their eternal shame, backed George Osborne’s maniacal drive to cut, cut, cut, welfare costs. That led to the present crisis, though admittedly the problem has been neglected or sidelined by all our political parties for a very long time.
Governments set up sober committees and commission weighty reports, but recommendations are quietly shelved. Till the next time. Just as individuals dread thinking about getting old, ministers dread producing policies to deal with the burgeoning ageing population. The powerful do not follow expert advice, and have chosen the path of least resistance. Their inaction and hesitancy comes out of political expediency and feebleness.
Here is what I think would help transform social care. First, taxes for all those except the low paid must be raised substantially. In Sweden, for example, where workers and bosses pay very high taxes, the elderly are exceptionally well looked after. Recently 4.3 billion Swedish krona to further improve provision. Our nationals are encouraged to think taxes are iniquitous or state theft while Scandinavians believe paying taxes is a duty for socially responsible citizens. In almost all international surveys Norway, Sweden, Denmark and Finland come top when it comes to the well being of the young and old. GB needs to get less vain and learn from these nations on how to create good societies.
Next, politicians should stop being defensive about migrant workers and tell the public that social care provision depends on them. In her last few years, my mother was washed and sometimes fed in her own flat by Nigerian, Lebanese and Rumanian care workers. I looked after her, but needed supplementary help which the council was happy to provide. She was lucky. Those days are gone. Councils can no longer pay for these services. Furthermore, care homes are closing as immigration rules harden. A childhood friend who runs a number of these homes told me that she is thinking of pulling out of the sector because excellent Filipino and Indian nurses are denied visas. The anti-immigrant hysteria which is leading to draconian new regulations will leave the most vulnerable without assistance. Has Mrs May told her people that fact? Have Gove or Boris or Fox or any of the hard Brixiters? No. They do not attend to such inconvenient truths.
Thirdly, those of us who own our homes can no longer expect to keep those assets intact when we grow old and need physical assistance. We will have to remortgage, downsize or sell up. The poorest in our country must get free and good care. The middle classes must make more of a contribution towards the costs. Of course they will hate the very thought and their friends in the media will kick up a storm, without offering solutions. The huffy, self righteous, entitled middle classes, of whom I am one, must now adapt to new realities.
We should also allow old people of sound minds to choose to die with dignity. I hope, when my time comes, I can see myself off. Parliamentarians have too long dithered over this fundamental human right.
Finally, tax the rich properly and give big tax breaks or cash to the many Britons who are looking after frail old relatives. They provide an essential service and yet remain in the shadows, unacknowledged and unrewarded.
Our MPs and ministers need to adopt radical ideas and bold interventions before the crisis in social care turns into a catastrophe. Will they step up? Or are they too scared to dare?
Edited Version I newspaper 15/12/16