Steve Fouch

Dilnot lays some tentative foundations

Steve Fouch is CMF Head of Communications. He has worked in community nursing, HIV & AIDS and palliative care. He serves on the International Board of Nurses Christian Fellowship International.
The views expressed do not necessarily reflect those of CMF.

Monday saw the publication of the Dilnot Report – the latest in a long line of reports and studies commissioned by government into how we, as a society, are going to care for our growing, and increasingly long lived elderly population.

This is more than an academic exercise.  A century ago, few people lived long past their fifties, and those that did were usually cared for in large extended families.  Medicine, good nutrition, public health measures and a steady increase in material prosperity have all led to extended life spans over the last half century in particular. At the same time our families have shrunk and become more mobile, so that the different generations seldom live in the same neighbourhood, let alone the same household.

At the same time, we may live longer, but for a significant proportion of that extended life span we are also likely to need care and support.  We have not eliminated all the problems of old age, especially not senile dementia.

So, with a growing, vulnerable elderly population, shrinking families that are less able or willing to care for them at home, society has to find some answers. Sadly, every attempt to address the hard questions has been ducked by successive governments because of costs and some of the other hard questions we have to face, and it looks increasingly likely the same will happen here.

On the whole, Dilnot’s proposals seem reasonable (although it is fair to say they tend to disadvantage those on middle incomes – the very rich and very poor are well catered for), sharing the burden between the individual and the state, and capping the total cost the individual will pay for their care at round £35,000.  Of course, it does not address the long term funding of care of younger disabled people (another major social challenge), although it does suggest that they should not have to pay for their care needs. And of course, onhealthy crestor Dilnot’s report is only focussed on the costs of residential care, rather than caring for people in their own homes.

This is a situation that we cannot shy away from.  It is often said that that a truly civilised society is marked by its care for its most vulnerable citizens. That we are having a debate just now about how we pay for this care shows how far we have to go. As we have blogged before, the big problem is that paid for care is not well regulated, and cases of abuse or neglect are widely reported (although hopefully still the exception rather than the rule).  At one time this care was the provenance of the family – but it would be using rose tinted spectacles to say that abuse of the old and disabled did not or does not still happen within the family.

So cost is not the only issue.  How we pay for care, and how we provide care of a good standard that affirms the value of the person are equally valid questions, and the latter was not really within Dilnot’s remit. One hopes that if the Government does grab this nettle (as ultimately they must) that quality of care will be considered with equal seriousness.

The saying goes that a cynic is one who knows the price of everything but the value of nothing.  Are we in danger of becoming a cynical society that balks at the costs of caring for our elders, and forgets the value they have as human beings? The next step from there is finding cost cutting ways to eliminate the care need – and the route of involuntary euthanasia for the very frail and senile is not a route we should even contemplate as a society. Let us hope instead that we will show ourselves to be a truly civilised society.


Posted by Steve Fouch
CMF Head of Allied Professions Ministries



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