Once and For All, Again

The new government has picked its defining mission, and it is a serious one. Andy Burnham has put social care at the centre of his first weeks in office and opened talks with the other parties to settle it for good. The instinct is sound. The diagnosis behind it is not. Britain does not have a social care question it cannot answer. It has an answer it will not pay for, and the record on that point now runs to twenty-seven years.

Start in 1999. The Royal Commission on Long Term Care, established by the incoming Labour government, looked at the means test that still governs the system today and found that relying on income and savings was neither efficient nor fair for a risk of that size. It proposed pooling the risk. The government took the cheap recommendation, free nursing care, and rejected the central one, free personal care, citing its very substantial cost.

Then 2011. The Dilnot Commission proposed a cap on lifetime care costs and a more generous means test, and this time the answer went further than a report. It became law. The Care Act 2014 legislated the cap with cross-party support. In July 2015 the incoming government deferred it, explaining that a time of consolidation was not the right moment to be implementing expensive new commitments. The deferral became indefinite. The law had passed; the money never arrived.

Then the pattern accelerated. A green paper on care funding was promised at the March 2017 Budget; five government-set publication deadlines came and went, and it never appeared. In July 2019 a new Prime Minister stood on the steps of Downing Street and promised to fix the crisis in social care once and for all. In September 2021 he produced the money to do it: the Health and Social Care Levy, fast-tracked through the Commons in a single day, raising National Insurance by 1.25 percentage points from April 2022 and forecast by the OBR to bring in around £12.4 billion a year. In September 2022 the next government announced its reversal. The rise was gone by November, and the Act was repealed before the levy had ever come into existence as the separate tax it was meant to become. The only funded answer in a quarter of a century of social care reform survived seven months.

Each retreat had a respectable case. The consolidation of 2015 was a real fiscal judgement, not a whim. The levy fell in the middle of an inflation shock, loaded onto the narrow base of workers' pay. And the appetite for cross-party talks now is not a ritual: care reform has to hold for decades to be worth anything, and a policy each opposition promises to reverse is not a policy, it is a truce that expires at the election.

But consensus is the one ingredient the record shows was never missing. The Dilnot cap had consensus. It had statute. It died anyway, because agreeing to a reform and paying for it are different decisions, and Britain has only ever managed the first. The mechanism is not mysterious. The benefit of care reform is diffuse and deferred - it accrues to people who are not yet old, against a catastrophe most will never meet - while the cost is immediate, certain and nameable. A government that announces reform banks the credit now. A government that funds it takes the pain now so that some later government can cut the ribbon. Every incentive in the system points one way, and four governments of both colours have followed it.

What is different this time is that the constraint has been said out loud before the talks begin. The National Institute of Economic and Social Research put it plainly this week: there is clearly no scope for increasing borrowing, so it is about choices. The institute expects inflation to keep rising into early 2027, and its director notes that every major shock this century has ratcheted the debt ratio higher and none of the increase has been reversed. The manifesto rules out raising income tax, VAT or National Insurance for working people. What remains is a short list the institute was candid enough to read out: the welfare bill, the triple lock, council tax reform, the VAT exemptions - and, once those are exhausted, the manifesto promise itself. Every item on that list has a name, a constituency and a front page waiting for it.

So the test of this attempt is not the commission, the communique or the warmth in the room. Warmth in the room is what 2014 had. The test is whether the government is willing to publish the loser alongside the promise - to name the tax, the cut or the broken pledge in the same breath as the entitlement, and to let both stand in the same document. Nothing in the record suggests the hard part is agreeing what care people deserve. The hard part is the invoice, and it has now been returned unpaid four times. The reform that matters will be the one that arrives with its bill attached.

An opinion of the house. The argument is ours; the record beneath it belongs to no one.