I’ve
never been a very good numbers person – not great on dates, and I’m the type
who might tell you, “There’s been a terrible explosion! 350 people were killed!
Or was it 3,500? Or 35? Er . . . not sure.”
But
I am good at grasping principles, and at joined-up thinking, and at
understanding human situations.
As
I’ve watched and listened and read during these weeks running up to the UK
election, I find it difficult to remember the exact data about the NHS, for
example – just how many hours doctors have to work or how many nurses posts have been
cut, or exactly what is the annual salary of the nurses who have had to resort
to feeding their families from foodbanks.
And
sometimes I don’t think quickly enough to answer someone’s point. For example,
the man who was talking to me in the street about politics the other day. I was
concentrating on staying calm and polite while he thrust his face about four
inches away from mine and said he wouldn’t vote Labour because Jeremy Corbyn is
a man of peace. “If someone comes at me with a knife,” he said, “I want a gun
in my hand!” He extrapolated from this an international imperative of
stockpiling nuclear weapons.
If
I’d thought fast enough, I might have pointed out that the problem with his
preferred system would be that the next time his attacker might have a gun in his hand – and then what? Surely what you want if a man comes at
you with a knife in his hand is a robust police force, and maybe good
negotiating skills and a well-resourced mental health provision. Our police force is in a desperate condition, defunded and cut back to the bone. Our mental health provision is evaporating.
I
did manage to think quickly enough to point out to a man insisting that there was
no point saving the NHS as its fundamental problem was old people aspiring to
live to be 300, that since his wife is an occupational therapist she’ll
probably lose her job if we have any more cuts.
But
the main thing I’ve been struggling to communicate is the grave consequences of
what’s being called the Dementia Tax.
This
is that proposal to fund social care from the equity of the patient’s home, all
bar £100k.
People
arguing in favour of this make it sound very reasonable – social care is
expensive, the money won’t be taken until the recipient’s death (so they won’t
suffer or be made homeless), and £100k is a generous amount to have left over
for a legacy.
But
there’s a gaping hole in this. What if the person who needs social care is not
the only one whose home it is?
Let
me sketch out a couple of possible scenarios.
Suppose
an elderly couple become increasingly infirm, but they have a son who is a
minister in the church – someone who is on a very low income and has lived in
occupational housing. Suppose that son, on retiring, didn’t take up the option
to have a church retirement house because he moved in with his ageing parents
to care for them. One of them is frail and needs to be taken to numerous
medical appointments, he has to do all their shopping and cleaning (and his
own) – but one of them develops dementia and cannot be left alone. Nobody can
be everywhere at once doing everything. So the son has to have help with necessary
social care. Then one of his parents dies. Perhaps at this point the house will
remain the property of the surviving parent, if it was jointly owned. But what
when the second parent dies? The son, now an elderly man, with very little in
the way of savings because his occupation was not highly-paid, will have to
sell the house to pay for the social care his parents had. In the area where I
live, a small 2-bedroomed terrace house is now worth over £200k, and you
couldn’t even get a one-bedroomed flat with no garden or separate kitchen for
£100k. It would be too late for the man to generate earnings or take out a
mortgage. In the rental sector there’s fierce competition for homes, private
sector rents are very high (even for bed-sits), and there is very little social
housing left. I think there’s a strong chance that man would become destitute.
Or
imagine a scenario where a woman has two daughters, both born in the 1980s, both
working as care assistants (valuable but low-paid work). During their adult
years, property prices have risen faster than their ability to save for a
deposit, and rented housing is beyond their ability to afford – but it’s okay,
because they continue to live in the family home. They enjoy each other’s
company, the mortgage is all paid off by an insurance pay-out when their father
died, and their mother has left the house to them in her will. It won’t be
subject to inheritance tax as her savings are very modest. Then she gets
cancer. She suffers a long, slow deterioration. To pay the household bills and
cover groceries etc, her daughters have to keep working. Their own care skills
are a good support to her, but as her condition declines she needs the extra support
of social care. After seven years, she dies. Because her daughters have
undertaken much of her care, there is only £85k owing to the state. The house
has to be sold to pay it, leaving £112k after estate agents’ and solicitors’
fees have been settled. This is a nice nest-egg, but unfortunately not enough
to buy a house. Where once the sisters would have been able to manage
comfortably, with both of them working and their home owed outright, now they
will face big financial problems. Even with the two of them sharing, care
assistants’ wages don’t go far (the hourly rate is £7.75).
The
proposed Dementia Tax would have very far-reaching social consequences,
stripping out the carefully accumulated security of families, transferring the
assets of the middle classes into the pockets of the very rich – because social
care, like the NHS, would be provided by private companies.
When
you look carefully at what such proposals mean, the magnitude of the
consequences becomes really shocking.
I
am not an especially political animal, and I personally believe most political
approaches work well if they are administered with goodness and compassion.
But
our present UK government is a cynical administration with a cavalier approach
to the concerns and sufferings of lower-income people. If they have another
5-year chance at government, the way of life we have enjoyed in Britain for so
long will be irretrievably lost, and the desperation of grinding poverty will
become a common phenomenon.
Please,
even if you normally vote Conservative, Lib Dem or Green, vote Labour this time
– unless you are voting tactically according to your neighbourhood. To save our NHS, to save
our education system, to maintain the stability of our social fabric and
infrastructure, we need a change of government. And in real terms this is a 2-horse race. The only way forward this time is Labour.
4 comments:
Thank you, Pen, for this nuanced and helpful post. I hope many people read it and take it to heart before Thursday.
:0)
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One of the first things I thought of. We are all being encouraged to take responsibility for our loved ones so what if people share their parents house to give care. What if people pool their resources but then, after many years find their parents have to go into nursing care? It's is going to be very difficult to untangle and there is no way that I can see it happening without the carers being penalised.
Yes - the sort of penalising that involves total destitution! Things being as they are, with such disparity between house prices and wages, if you get knocked off the property ladder in late middle age, then renting is your only option. And if your occupation for some years has been as a carer, living frugally on an elderly parent's pension and savings, what are the chances of easily getting a job? And even if you did, where I live many rents exceed the wages of many individuals. You'd need several people sharing to afford private sector rental. But if you've spent years as a primary carer, it's very isolating. The problems this throws up are horrendous. I do believe wealthy people simply don't grasp the issue. They think it's about already secure people grumbling because their windfall/nestegg inheritance is going to be less than they hoped. They think this is about the relative size of cash bonuses. They don't realise how people live, and how far one income, one house has to stretch. *Six* of us live in our house, all on very low incomes. Imagine if it belonged to one of us, elderly and frail, who needed round the clock dementia care!
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