Can We Still Fund Cradle-to-Grave Care?

Liz Emerson looks at the wider implications of the alarming EHRC report on the quality of council-run home care

The Equality and Human Rights Commission (EHRC) November report into council-run home care for the elderly announced a “systematic failure” in the way care is given in the UK. The Report highlighted that the care given is inadequate, the providers are poorly trained, and services have been cut, leaving staff rushed off their feet.

These vulnerable people are our parents, grandparents and great grandparents. They deserve better, we know.

And in the beginning…

At the other end of the age spectrum, just last week the National College of Midwives Chief Executive, Professor Cathy Warwick, said the NHS is short of 5,000 midwives, having to cope with increasing numbers of births, more complex deliveries and dwindling resources. In 2010 one London unit had to close temporarily on 140 different occasions.

These vulnerable people are our children, grandchildren, and – if we are lucky enough to be around – our great grandchildren. They also deserve better, we know.

The problem is how we, as a society, and how we, as individuals, decide to deal with the crisis before us. How do we balance the needs of an increasingly ageing and long-lived society with the needs of new life and lives to come? How can a projected smaller number of working-age citizens provide the care needs?

Painful Choices

Whether we like it or not, lowering our expectations of entitlement may become the new narrative:


If we want to be a “civil society”, should we not as individuals accept that more taxation will be required to fund the state-provided care needs of older and younger vulnerable members of society? Should that tax not be spread fairly across the generations? For example, perhaps National Insurance should be introduced to those older generations re-entering the workforce whilst also claiming a pension?


If, as a society, we choose not to provide more welfare services via taxation, then will we need to focus more on what we fund and how we fund it.  For instance, universal benefits (notably the winter-fuel allowance, free bus passes and free TV licences) are not means-tested and go to large numbers of people who do not need them: cutting or reducing these would make up to £3bn a year available for better targeted redistribution.


Will new education programmes be needed to move the public towards a post-consumer society, where responsibility for our own care over a life course becomes ingrained in our thinking? Not “the State will look after me” but “I will look after myself and others, if they require my help.” The proposed automatic enrolment in pension schemes in the private sector for younger generations is one way to achieve this aim.


Do we not as a nation need to question our expectations of current pension deals when we can hope to live another 30 years post-retirement? Is that a fair deal to the rest of society?


If we do not wish to have higher taxation, perhaps a better way to find funds in times of crisis would be to encourage greater philanthropic giving.  The newly established “Fuel Our Youth” campaign  suggests the 75% of older generations that do not need the winter fuel allowance given to anyone over the age of sixty should donate their £300 to impoverished younger generations.

Is Willetts right?

Can we simply not afford to fund the home care and healthcare needs of older generations outside the family structure? Should we instead return to intergenerational living and take back care for the elderly into the family bosom?

However we cut the cake, difficult choices affecting all generations will have to be made.  Ultimately are we not all individually responsible for our long-term care, irrespective of where and when in time we were born?

As David Willetts implies in The Pinch, perhaps those generations who were lucky enough to have taken advantage of low taxation, high interest rates, and a booming economy, and who still did not save enough, now need to lower their expectations of state entitlements so that more people can have better living standards across all age groups.