25 October 2013

The Dilnot Commission was set up in July 2010 by the Coalition, tasked with making recommendations for changes to the funding of care and support in England.

Yesterday – over two years since their recommendations were published and six months since the Coalition’s care bill first went before Parliament – we brought back together the Commission Chair Sir Andrew Dilnot, Commissioner Lord Warner, former Social Care Minister Paul Burstow MP and Michelle Mitchell, former Chief Executive of Age UK, to reflect on how and why the Commission worked.

Many of the lessons our speakers identified chimed with the Institute’s analysis of why the Turner Commission on pensions succeeded:

1.Frame the problem
The Dilnot commissioners quickly realised that although a huge amount had been published on the funding of social care, the policy problem had not been clearly articulated before. There was no consensus on what it was they were trying to solve. To this end, they dedicated the first few weeks of their work to reading through existing research and working out how to frame the problem. The phrasing they settled on, ‘the possibility of needing long-term care is the one risk that everyone faces, but that no-one can insure against’, resonated widely and, in Dilnot’s own words, ‘made finding an answer so much easier’.

2.Keep it small
As with Turner, the limited size of the Commission allowed members to build trust and made it much easier to get consensus on conclusions, something unwieldy past royal commissions had struggled with. It was not just the size of the Commission they kept small though, but also the number of recommendations that were made in the final report. By producing only ten, the final recommendations were focused and manageable which – as Paul Burstow MP argued – helped maximise their impact.

3.Commissioners who can do politics

Again, like Turner, the Commission was helped by being able to leverage ‘small p’ political experience. Commissioner Lord Warner, a former Labour Minister, was able to use his familiarity with Westminster and his insight into how Whitehall worked to navigate the politics of government and provide crucial insight into how the politics around their recommendations would play out.

4.Be open with stakeholders
The debate on social care funding was – and remains – a crowded and contested field and thus the commissioners spent much of their time talking openly about their work and conclusions with civil servants, campaigning groups, academics and journalists. This active and transparent engagement activity helped strengthen the Commission’s work and enabled them to build a coalition of actors who united behind the final recommendations and kept up the pressure post-publication.

Yesterday’s event did not just echo our Turner Commission analysis though, but highlighted new lessons on how to make reviews work:

5.Leave room for negotiation

Although the final Dilnot report and recommendations were firm and robust, the commissioners purposely avoided making their plan for social care funding unnecessarily detailed. The recommendations left room for the government to follow spirit of the Dilnot report but negotiate policy details with the multitude of interests it would inevitably face having to bargain with. And by leaving the question of how to fund the changes open, they prevented critics focusing on that, rather than on their proposals for the problem at hand.

6.‘Keep the plane in the air’

The final message was that the end of the Commission is not the end of the process. Andrew Dilnot estimated that even after the Commission completed its work and launched the final report, he and the other commissioners gave upwards of 100 presentations and met with an untold number of stakeholders. Post-Commission engagement and advocacy was crucial for continuing to build support and awareness of the Commission’s findings and kept the issue live – even when it looked ‘dead in the water’. In the words of Paul Burstow MP, this activity helped ‘keep the plane in the air’.

The speakers at our event were keen to emphasise that strong process and planning alone cannot guarantee success though. As they readily admitted, the Dilnot Commission benefitted from things that were beyond their control, not least timing. The Commission started at a point when there was consensus that something had to be done about the future of social care funding, even if there was no agreement about the solution. Further, its work began at the start of a Parliament, rather than the end when most politicians’ attention is elsewhere. And panellists thought that coalition government itself helped create an environment which prevented this issue being shelved again – the Commission was a commitment in the coalition agreement and could not simply be buried post-report.
For any Commission then, success will rely both on robust process and a healthy dose of luck.


my mother will probably have died and lost everything before this reform actually happens (if it ever will)But i can assure you that they will take no more from me or my family,and i suspect that there are a lot of families doing the same.They seem to have money to waste on other unnecesary things but think nothing of takeing from the people that provided the funds for them,in the beginning,by working and paying their taxes etc.

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