MPs are urged to end inaction on social care reform

BMJ 2012; 344 doi: (Published 03 January 2012) Cite this as: BMJ 2012;344:e12
  1. Matthew Limb
  1. 1London

A coalition of experts has called on politicians of all parties to agree urgent reforms of adult social care in England, warning that the current system perpetuates “terrible” abuses.

More than 60 senior figures, including peers, independent advisers, representatives of health and social care organisations, charities, and faith groups, have written to the Daily Telegraph urging “fundamental and lasting reform” of a system that they say harms society, the economy, and the dignity of elderly and disabled people (

Signatories to the letter include Hamish Meldrum, chairman of the British Medical Association, Brendan Barber, general secretary of the Trades Union Congress, and representatives of the British Red Cross and leading health insurers.

In the letter, published on 3 January, they say that politicians are failing to meet the challenge of supporting increasing numbers of elderly people, “resulting in terrible examples of abuse and neglect in parts of the care system.”

The signatories warn that an estimated 800 000 elderly people are being left without basic care and as a result are “lonely, isolated and at risk.” Others face losing their homes and savings because of soaring care bills, while disabled people are deprived of the support they need to live independently.

The letter says that more and more people are forced to give up work to care for older or disabled relatives and that many of these carers are pushed to “breaking point.”

It continues, “Our NHS is also paying the price, as a lack of support leads to avoidable hospital admissions and then keeps older and disabled people in hospital beds because they cannot be cared for at home.”

There is now widespread pressure to reform the funding of adult social care and growing concern that over many years successive governments have failed to honour pledges to tackle the problems.

In 1997, in his first speech as prime minister to the Labour Party conference, Tony Blair said that he did not want to see children grow up “in a country where the only way pensioners can get long term care is by selling their home.”

The current coalition government is expected to produce a white paper on social care by April in response to recommendations from the independent Dilnot commission into the funding of care and support, published in July 2011 (BMJ 2011;343:d4261, doi:10.1136/bmj.d4261). Andrew Dilnot, an economist, recommended a new partnership model under which people would pay up to a maximum £35 000 (€42 000; $55 000) towards the cost of their care and be eligible for full state support beyond that.

He has since said that the country’s economic woes should not be an excuse for inaction and argued that it was “nonsense” for anyone to suggest that reform would be too expensive to implement (BMJ 2011;343:d7689, 28 Nov, doi:10.1136/bmj.d7689).

The signatories to the Daily Telegraph letter say that reform is a matter of “duty as a nation” and that it is time for politicians to show leadership by seeking agreement.

They write: “With new cross-party talks on the future of care, we are closer than ever to reaching a new consensus. We urge the government and the other party leaders to seize this opportunity for urgent, fundamental and lasting reform.”

The care services minister, Paul Burstow, told the newspaper that the government was taking leadership on the issue. “The coalition agrees that the reform of social care—and the dignity and independence of older and disabled people—are an urgent priority,” he said.


Cite this as: BMJ 2012;344:e12