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Boris Johnson must now deliver his promised plan to fix social care  

Boris Johnson now owns responsibility for fixing a broken social care system.

Adult social care didn’t derail the Conservative election campaign as it did in 2017, but Nick Davies argues that Boris Johnson now owns responsibility for fixing a broken system.

While Labour used its manifesto to set out an ambitious plan to substantially increase funding and provide free personal care for over-65s, concrete Conservative plans to fix social care were notable by their absence.

The Conservative manifesto pledged that the £1 billion additional funding (split between adult and children’s social care) announced in the 2019 spending round for 2020/21 would be replicated in each year of this Parliament. However, the Institute for Government’s Performance Tracker – published in partnership with CIPFA – found that this is unlikely to be enough to meet rising demand, and is nowhere near enough to widen access to publicly funded care or to safeguard families against the potentially catastrophic costs of care.

Finding cross-party consensus will be hard but it is possible

Much now rests on the Conservatives’ other manifesto pledge on social care: to build cross-party consensus on a long-term solution for adult social care. There is good reason to be cynical about the prospects for progress. The government has promised to make a start on this within its first 100 days, but it is now more than 1,000 days since the Conservatives promised a yet-to-be-delivered green paper.

The government has previously been unable or unwilling to find cross-party consensus, so why should it be any easier after such a rancorous general election and with the most difficult stage of Brexit to come? The risk is that seeking cross-party consensus becomes an excuse for once again kicking the issue into the long grass.

Yet there also reasons to think cross-party agreement is possible. A former adviser to the health and social care secretary recently argued that the Conservatives have detoxified the issue of social care through saying so little about it in their manifesto and, as a result, have now given themselves space to find consensus in the new year.

The beginning of a new Parliament is certainly the best time to try, as parties find it easier to compromise when there is no imminent threat of an election. There is also some agreement on the outline of a deal, with all parties committed to a cap on care costs. Finally, social care is a key issue for voters, and with services standards likely to decline further over this Parliament it may be that the political cost of inaction will finally outweigh the risk of action.

An independent parliamentary inquiry stands the best chance of cracking the social care problem

The government will not make progress by arranging direct talks between parties – there is too much distrust between the opposing frontbenches. Nor should it plump for a royal commission. Our research suggests that a parliamentary inquiry, modelled on the Parliamentary Commission on Banking Standards, is most likely to break the deadlock.

Members of the inquiry should be drawn from both the Commons and Lords, and it could be chaired by the new chair of the Health and Social Care Select Committee – who will already have a measure of cross-party support after being elected by MPs in the new year. It could be set up relatively quickly, with the secretariat drawn from existing select committee staff.

If it is to succeed, the inquiry needs the full support of the prime minister and the chancellor – the last major attempt at reform, the Dilnot Commission, was killed off by George Osborne, the then chancellor. Opposition parties also need to be involved from the start and should be consulted on the terms of reference and membership of the inquiry. This worked well for the Dearing and Browne reviews into higher education.

The inquiry should carry out extensive public engagement to improve the quality of recommendations, and help build public support and awareness – currently, most people do not understand how the system works or their levels of entitlement to publicly funded care. Finally, we recommend that the inquiry publishes an interim report, to frame the argument and prepare the ground ahead of its final recommendations. Both approaches were used very effectively by the Pensions Commission.

It is far from guaranteed that the Conservatives will be able to forge a cross-party consensus, but if the government can’t put adult social care on a sustainable financial footing, then it may pay the price at the next election. Staying silent on social care may have worked this time, but it won’t be an option when the country next goes to the polls.

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