Planned immigration is needed to deal with our social care crisis: Andy Brown

Everyone now seems to agree that it is important to fix social care if we are to improve the NHS and treat our aging population with some dignity. There are, however, a few pesky problems to sort out. We don’t have enough money. We don’t have enough facilities. We don’t have enough staff.

Dealing with those problems is exceptionally difficult. Making trite political promises that the cost of care shouldn’t fall on tax payers is much easier.

Let’s start with the problem of the money. The birth rate in Britain is currently under 0.7 children per person. We are expecting to have three million more people over 65 years of age by 2045 and we already have eight million. That’s a lot of people who might need care.

A basic council funded care home place costs £1,350 a week to provide. If the person needs dementia care the cost is more likely to be £1,900.

The cost of providing care for people with few financial resources falls mostly on the local authority. If the individual needing care has assets worth only £23,250 then it is the individual or their family that pays.

Those families face an unfair lottery. If your parents remain healthy and die after very short illnesses then the family wealth will remain intact and you can inherit £1m before you start to pay a proportion of the remaining inheritance in tax. If your parents require years of care then it will eat away at any savings or equity in their home until only £23,250 is left.

If any government is going to change that and pay even a proportion of the cost of providing care for those with assets then there has to be a hefty source of new taxation to get the money.

I think the least painful way of doing that is by raising inheritance tax levels so the burden is shared more widely. Anyone thinking differently has to come up with a less painful way of finding billions more for government spending.

Those who make crude promises that the money can come from cutting welfare or the NHS budget are just dodging reality. The biggest welfare budget is the cost of pensions.

I can’t see many elderly voters queuing up to support reductions in their state pension to pay for the cost of their future care. Achieving efficiency savings in the NHS is certainly possible in theory but delivering them in practice without serious negative consequences has yet to be achieved by any government.

The most realistic solution to the financial challenge is some kind of means tested contribution from the individual and some support from the government paid for by taxation. It is more reasonable to tax inheritance than to place further tax burdens on the young or on business.

Even if the money can be found the next problem is that there aren’t enough places in local authority care homes. The network of privately funded ones is no longer typically run by charities. It is a booming business with good profits to be made by chains of providers under remote ownership that might ultimately lie with an international hedge fund.

The private market has produced a strong network of provision of high quality, high expense places for those who can afford to be looked after in comfort. In a modern care facility you are more likely to come across the smell of a nice glass of wine and some French cooking than of stale cabbage.

The network of publicly funded care places is much more limited and will take time, investment and imagination to fix. You can’t build new care places in a few weeks.

Every new place that is built will take pressure off long term occupation of hospital beds and cut the costs to local authorities of buying places from private providers who can sometimes cynically name almost any price when there is no alternative supplier.

It also helps if we reduce the number of new care homes needed by assisting more people to be able to carry on living in their own homes. That requires staff who have driving licences and are trained to recognise and deal with multiple health and social circumstances.

Which is where we hit the reality of the third big issue. There simply aren’t enough young people in this country and few of them see care as a rewarding profession to work in.

There is only one practical fix for that problem. Planned and managed immigration.

We are going to have to attract good quality care staff from abroad and an important part of the package we need to offer is the opportunity to become British citizens as a reward for years of looking after elderly British people.

Instead of facing that reality the government has just placed severe limits on the ability of anyone working in the NHS or in care homes to become a British citizen. It is going to take a lot of political courage to change that.

If that courage turns out to be in short supply then our politicians need to explain where the staff are going to come from to look after us in our old age.

Andy Brown is Green party councillor for Aire Valley.