Cowper’s Cut 440: “And would you like cuttings of long grass with your adult social care reform?”
Adult social care’s Bank of England 1997 independence moment, that was not.
PM and Mascara Kid Andy Burnham’s speech on social care reform turned out to be a heavily-trailed nothingburger. You couldn’t even call it highly-processed food. It was regurgitated slop.
The Casey Commission’s timescale has been slightly shortened, to autumn 2027.
And, yay: there are to be productivity gains! Even more will be done with existing resources. Cowper’s Fifteenth Rule Of Health But Social Care is that productivity gains always work and always make everything better.
But perhaps best of all, there are to be cross party talks on adult social care reform. Oh, sorry, I mean cross-party talks. Or do I?
How is the as-yet-unspecified reform to be funded? Don’t ask The Mascara Kid! He’s just the Prime Minister. And it‘s only money.
Mr Burnham had a chance to do something big and bold on the offer and the funding of adult social care while his political capital was at its maximum, and he absolutely failed to take it. The Casey Commission’s late 2027 report will “look at” creating a National Care Service. Big deal: I will look at the Aegean Sea, but I’m fundamentally not going to swim it.
Instead of this, the Number 10 press operation issued ‘four principles’:
- The system must allow people to move seamlessly between hospitals, home care and community services.
- This service must be fully and sustainably funded
- The service must start with prevention, supporting people to live independently for longer
- Citizens’ needs must be at the heart of plans, removing budget battle lines between organisations and making sure local social, primary and community care works together effectively
Isn’t it wonderful? It contains just about every policy cliché apart from ‘God is love’ and ‘please adjust your dress before leaving’. I particularly admire “fully and sustainably funded”: it smacks perfectly of ‘in the fullness of time’.
You will notice that they did not actually publish a text of The Mascara Kid’s speech, which may well be because if you read it, you realise even faster that it doesn’t say or do anything useful. (UPDATE: a couple of hours later, its text was put up online.)
And in a particularly vacuous bit of rhetoric, Mr Burnham told his unlucky audience that to him, carers “should be the best-paid people in society, not the worst”. Which means that The Mascara Kid’s National Care Service, should it ever progress beyond rhetoric, will be Very, Very Expensive Indeed.
Mr Burnham’s simpering rhetoric on carers’ pay is, of course, just that: it is Not Going To Happen. The real problem politically is that adult social care reform may not, either. Sure, Mr Burnham’s remarks that the NHS “will collapse” without social care reform gives him a short-term tactical weapon against the Conservatives and Reform, but at the cost of the biggest medium-term hostage to political fortune imaginable.
This is how it goes: the cross-party talks, after a decorous interval, will descend into cross party talks, and then end in a recriminationfest. All parties will blame the others. Mr Burnham will then try to lay all the blame for inadequate NHS performance at the feet of social care reforms having been dashed by his evil opponents.
There are two slight problems with this approach: public expectations of the NHS are catastrophically low, with no obvious route to prompt recovery; and the public doesn’t know what social care is and when they are told about it, they think it’s free like the NHS.
And Mr Burnham having ruled out an early general election (for now, unless and until opinion polls improve for him, which they may thanks to Faragemania being over), the timeline for the next general election is very much the medium term. 2029 is not that far away, but it’s just far enough away.
Recommended and required reading
I didn’t spot Shaun’s very interesting Times story about NHS England suppressing investigation reports.
Caitlin Tilley
Simply magnificent HSJ story about “a scammer who lied to secure 13 NHS management and admin jobs – including at NHS England and NHS Digital – has been jailed for four years.
“Amran Hussain was found to have applied for 2,071 NHS posts and fabricated employment history, qualifications, and references to secure 13 roles, which resulted in a financial loss to the NHS of nearly £170,000. Ten of the jobs were at Band 8, the second highest in the Agenda for Change national NHS pay structure.
“These include Mr Hussain’s roles at NHSE, as a national delivery officer, and NHS Digital, as a senior engagement manager for the “frontline digitisation” programme. Two were at band 8d, which come with salaries of up to around £109,000 (see full list of the 13 jobs below). He was caught after applying for and being offered the role of deputy chief operating officer for urgent care/transformation and operations at Devon Partnership Trust in 2021.”
“We found no noticeable improvement in discharge performance among trusts using [Palantir’s patient-tracking tool] … a gradual upward trend in performance” observed at NHS trusts before they had deployed the Federated Data Platform “continued at broadly the same rate”. Evaluation of Palantir’s FDP software by the Health Foundation shared with the Financial Times finds “no noticeable improvement” in performance, and “no meaningful difference” in discharge delays.
Another first-rate Sam Freedman piece on the benefits and big risks of political devolution within England.