Who Cares?

Page 94: The Private Eye Podcast

The episode covers three distinct areas of concern: the political struggle over social care funding in the UK, a high-profile legal dispute

Key takeaways

• Andy Burnham is making social care a central pillar of his political platform, attempting to avoid the 'death tax' branding of previous years.
• The division between NHS healthcare funding and local council social care budgets creates a systemic crisis for elderly patients.

Main topics

• Social care reform and funding
• Earl Spencer vs Piers Morgan legal dispute

Notable quotes

It is as if the entire political class have dementia, frankly.

Conclusion

The episode serves as a warning about the erosion of truth in both pol

Transcript preview

Speaker 2 (0:00) Page 94, The Private Eye podcast. Speaker 3 (0:03) Hello and welcome to another episode of Page 94. My name's Andrew Hunter-Murray and I'm here in the Eye's new studio with Helen Lewis and Adam McQueen. We're here to discuss all sorts of things that have been in the news since the last issue of the magazine. We are slap bang in the middle of the Labour conference. We're recording this on Monday. So at the time you watch this, you may have just switched over from Andy Burnham's big speech. But one of the things he will be talking about is social care, which he has made an enormous part of his offer to the electorate. trying to convince everyone that we really, really need to do something about social care. Helen, why is this such a big thing for him? Speaker 1 (0:38) Well, he's been on this case since 2010 when he was a health minister under Gordon Brown. And if you remember, he got... kind of shanked by the Cameron Osborne administration who called it a death tax, his proposals back then. But he's, you know, he's always had this. When he was mayor of Manchester, he asked for the kind of latitude to try and try out some proposals in Manchester. I was on a panel with him. You remember that Labour conference where he was sort of seen as the coming man a couple of years ago and he was going around in his little... Fred Perry Polonek. And I mean, in sort of every Labour Party conference the last couple of years. And I made some sort of like slightly sad joke about the fact that obviously he'd tried this before that Keir Starmer had tried it. And, you know, it has been something he's been going on and on about for a really long time. I think given extra charge by the fact that his father died having suffered from Alzheimer's for many years not long ago. Speaker 2 (1:22) But it's also something that everyone has been talking about for a really, really long time. I mean, the general consensus, and it's as far as the consensus goes, for the last at least 15 years has been that something needs to be done about social care and something needs to be done. But there's absolutely no consensus on what that should be. And it's literally at least two elections. So the 2010 one, when it was branded by other parties as the death tax, the 2017 one, when Theresa May tried to come up with a solution for it in her manifesto, it was branded as dementia tax, wasn't it? It's one of those things that everyone can agree that something needs to be done on, but no one can agree quite what. The problem Speaker 3 (1:54) is there's a big division between healthcare, NHS care and social care. So I actually re-listened to an episode we did of Page 94 in 2015, Speaker 2 (2:03) where Speaker 3 (2:04) I was talking to Phil Hammond and Heather Mills. Both of them were saying, this has been a problem for a really long time. We really need to get a grip on this. As far as I can tell, almost nothing has changed. in the time since we recorded that episode. So that has had an impact on millions of families, millions of elderly people who are spending all their money on care. that is not state-provided, people who are selling their homes, families who are having to give up all of their time and become unpaid carers, and the state is really relying on their goodwill and the fact that people like caring for their families and they feel the need urgently to do it. But this is not a sensible way to run a system. So the basic problem is one about the division between health care and social care. If you have cancer, for example, and you need help with various things as part of your recovery, maybe that's... being visited at home, whether that's getting up in the morning or getting dressed or maybe some meals cooking. If you've had cancer, that might well come from the NHS budget and you will probably get that, right? Because that's central government funding. If you have, let's say, dementia, that funding is supposed to come from the social care budget, which your local council administers. And councils are so strapped for cash, as you say, that there might well not be that money there. It's very, very hard to get social funding. So lots of people simply pay for it themselves. get through all of their money right down to the last. It's £23,250. Once your assets shrink to that level, the state steps in. But it's a complete lottery as to whether you get care or don't. It's an insane way to run a system, and yet it's just been relied on because the alternatives, apparently suggesting more tax to pay for it, immediately the other side will always Speaker 2 (3:42) brand it a death or a dementia tax. It's mad. It's a madly disjointed system and it also has a massive knock-on effect on the NHS as well. So I was in the position four years ago of a member of my family who was at the point where they were in hospital and needed to go into full-time care. Speaker 3 (3:57) It Speaker 2 (3:57) was a matter of weeks and weeks that that person was in hospital for. And I remember speaking to one of the nurses on the ward who said probably a third of the patients in that hospital were in exactly the same position. Speaker 2 (4:07) fit to leave hospital. They didn't need any more treatment in hospital, but there was nowhere for them to safely move on to. The backlog in the system was such that effectively they were just becoming bed blockers. So it's not just about local councils, you know, it impacts the NHS in an enormous way as well. Yeah, which is also very expensive. And it's something that taxpayers are paying for. So this mad idea that anything that's done about it will be a new huge burden on taxpayers is nonsense. This is costing all of us money all of the time and suffering for people who are stuck in hospitals or... you know, substandard care that isn't what they need and for their families as well. So as politicians have been saying for a while, someone has got to grasp the nettle and sort this out. The Speaker 1 (4:44) trouble is, I think there have been lots of good recommendations over the time that have been nuked for various reasons. So the Dilnock report was when 20... And that essentially proposed a cap on costs, which to me seems a very fair way to say you are responsible for the first X amount if you have it. One of the things that Andy Burnham previously did was talk about an estate tax. Now, I personally can't think of a better time to pay tax than after I'm dead. But this, for some reason, is massively unpopular generally. With people, I think, who've got kids, they want to pass it on to them. But there is this problem, which is that the current generation of retired people are the wealthiest generation. And there is an issue where are you going to ask working age people essentially to preserve the inheritances that those people can pass on to their kids, which will only be a certain percentage of them. That is likely to increase inequality, right? There will be a generation of people who just get massive inheritances. That trickles down the system. So I'm kind of nervy about the idea of this being paid for by working age people without the kind of input from... from wealth from that generation that has built up wealth. So I think there should be a kind of, there should be something that is kind of proportional to people's, you know, how they have managed to accrue wealth during their lifetime. Speaker 2 (5:52) I was trying to think of a counter argument for this, and the only one I think of was, well, at least then some of that, you know, we've got a problem at the moment where younger people are not getting on the housing ladder. There's massive inequality like that. So at least maybe if money is being passed down through families. But it's not even going to them, is it? Because, I mean, unless you're very unfortunate and lose your parents at an extremely early age, it's going to people sort of my age and above, in their 50s and 60s, who are probably the next proportionately wealthy kind of trance of the population. Speaker 1 (6:15) And also those people who might be then, you shouldn't get in a situation where your 50-year-old's the only way their retirement works is if they get an inheritance. And if something nukes that, then things are unsure for them. But we should be kind of clear about the scale of money that's being asked. So the Health Commission said $16 billion a year. which is equivalent really, like these are very rough numbers, to essentially 2p on income tax. So you're talking about somebody on the median income probably about £700 worth of tax a year. Anteburnham said that's higher, it's not going to be that much. But if you were going to provide NHS levels of universal coverage from people, it is quite, it's a chunky old bill. We Speaker 3 (6:49) should say this is England in particular, and I think Northern Ireland as well that we're talking about. In Scotland, the care is kind of provided if... If you go into a care home, you might face a bill for accommodation. But, you know, your care is provided if you're visited at home, that kind of thing. Can I just sort of do the back and forth of it now, of how completely mad this is? Right. When they were last in government, Labour proposed a national care service, right? Some people would have had to pay from their inheritance to fund that. That got branded a death tax. Labour lose that election. OK. David Cameron commissioned this review. The review proposes a lifetime cap. No one has to pay more than £35,000. Yep. that doesn't happen. It's not implemented. Then under Theresa May, people... Well, Speaker 1 (7:34) they did sort of randomly announce that in the middle of an election campaign, which was a very kamikaze way to do it, but yes. Speaker 3 (7:39) Under Theresa May, the Conservatives propose people getting care at home pay for the costs if they are worth £100,000 or more, right? If they have over those assets. Labour calls this a dementia tax. May loses the election. It's not implemented. Boris Johnson pledges a lifetime cap on personal care costs of £86,000. A new levy to pay for it, not implemented. Rishi Sunak, when he's Chancellor, introduces a new levy on national insurance to fund a reform of social care, which Liz Truss then scraps. It is... It is as if the entire political class have dementia, frankly. They have just completely forgotten that this is urgent and it needs resolving. I'm sorry, that's probably very tasteless to say, but it's true. No, it's Speaker 1 (8:19) fair, but it's a very tasteless situation. This affects, you know, one in ten people or something like that, but for those people it is just a life-changing experience that kind of just sucks up all of their attention, all of their finances. So it's like playing a very grim... The worst one, I think, is maybe Keir Starmer comes in 2024 and says, let's have a commission that report in 2028. And you're like, so just before you're a year before your planned next election, you're going to go, who fancies