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The Citizens’ Assembly, Part II

Source: PSE Aug/Sept 2018

In a follow-up to his article in PSE June/July, director of Involve Tim Hughes provides an update on the recommendations of the Citizens’ Assembly on Social Care – namely, that social care should be free at the point of use.

The adult social care funding system has been in urgent need of reform for many years, but our political system has been unable to find a workable solution. Politicians have felt unable to take the difficult decisions needed to fund adult social care sustainably. This has left the social care system close to crisis point and contributed to a sense among the public that the current system doesn’t work, and that politicians are ducking the big issues.

In April, the Health & Social Care (HSC) and Housing, Communities & Local Government (HCLG) committees made history by commissioning the UK Parliament’s first-ever citizens’ assembly. The Citizens’ Assembly on Social Care, which Involve designed and delivered, brought together a representative group of 47 randomly selected English citizens to consider the question of how adult social care in England should be funded in the long term.

Through a combined total of over 1,300 people-hours of learning, deliberation and decision-making spread over two weekends, the assembly members developed detailed recommendations for funding adult social care for both working age and older people. Sarah Wollaston MP, chair of the HSC committee, commented: “It was extremely encouraging to see such a mix of different people coming together to deliberate on these big issues so thoughtfully. The way the event was organised maximised participation and those attended clearly felt able to question, challenge and debate the issues freely.”

The assembly concluded that social care should be publicly funded through national taxation, and free at the point of delivery like the NHS. The assembly favoured the use of a new compulsory social insurance scheme for over-40s, a general increase to income tax, and/or an earmarked increase to income tax to raise the additional money required to fund social care. It rejected the use of council tax, inheritance tax or VAT.

The group was keen that any private financing element of social care should be as generous to those needing care as possible, and protect individuals from catastrophic care costs. They therefore recommended raising the assets floor, meaning nobody with assets below £50,000 would have to pay; and introducing a payment cap, meaning nobody would have to pay more than £50,000 towards their care costs throughout their lifetime. The assembly also recommended exempting the family home from the calculation of a person’s assets.

The report of the parliamentary committee’s inquiry (into which the assembly fed) closely mirrors the recommendations of the assembly, calling for, among other things, a tax on over-40s to help pay for social care. It echoes the assembly’s aspirations for social care to be free at the point of use for both working age and older adults, be of higher quality, include better support for carers, and use national earmarked contributions to help pay for the changes.

The committee’s report is surprisingly radical, considering it had to be agreed by politicians from across the political spectrum. The assembly demonstrates how putting people at the heart of decision-making can help politicians to build consensus.

Clive Betts, chair of the HCLG committee, reflected on the assembly’s contribution: “If we are to ensure that the social care system of the future is sustainably funded and provides the high-quality care that people deserve, then any proposals must command not only a political consensus, but also the support of the public. The views of those that took part in our citizens’ assembly have been vital in informing our thinking, and the model also provides a possible route for further public engagement and building the support that any reforms will need.”

The assembly sets a precedent for how the UK Government should engage the public in the future in an age where politics has become increasingly fragmented and distrustful.


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