Policy by review: The Social Care Commission

In July 2010 the Coalition established a commission chaired by Andrew Dilnot, then Principal of St Hugh’s College Oxford and former director of the Institute for Fiscal Studies to “make recommendations on how to achieve an affordable and sustainable funding system or systems for care and support, for all adults in England, both in the home and other settings”.

Two years after the commission reported, and now that the government has accepted the principles but not the details of “Dilnot”, this event reflected on the pros and cons of this approach to policy making with key individuals inside and outside the commission. It also explored the particular challenges of tackling the problem of finding a fair way of funding social care. This event built on our earlier work on the Turner commission on pensions.

Report

Sir Andrew Dilnot, began by commenting that being on the Commission was “enormous fun” and also an exciting opportunity because social care is a hugely important issue which he felt was being tackled at the right time. The process was characterised by the small group of the Commission and their small, “outstanding” secretariat. The Commission felt that the policy question they were being asked to solve was itself unclear and so time was spent – from July until the end of December – working out the nature of the core problem with social care. They decided that problems arose from its being the one significant issue that everyone faced, but where resources could not deal with it, and from that definition, the solution became more obvious.

He identified a number of lessons learnt from conducting the Commission, including:

• not allowing tricky but minor implementation issues to get in the way of planning a solution
• there were benefits from starting work early in the life of the Parliament
• the period after the recommendations were published was very important, a fact which he had underestimated.

Lord Warner added to the above analysis, suggesting that “the good guys” in the social care debate had been the Lib Dems, who had suggested an Independent Commission before the election. He observed that, while those on the Commission were all good at detail, they were not collectively “detail obsessives” and that had worked to their advantage, aided by their narrow focus and a strict timescale.

The Commission had produced a short report with strong key messages which had enabled stakeholders and others, such as the media, to keep parading its key points during the times when it felt like the report might die. The report was successful because it contained ‘architecture’ for social care, rather than a complete system, which provided so lots of room for government to negotiate around. 

Michelle Mitchell explained that the Coalition had been an important factor in moving the debate on social care forward because the desire of the Lib Dems for an independent commission had led to it becoming part of the Coalition Agreement. She felt that Andrew’s chairmanship had been critical to the Commission’s success because he quickly built trust and created a dialogue with stakeholders. The timetable of the Commission enabled key campaigns to have focus, and encouraged the sector to “raise its game” when thinking about policy and evidence.

The Care and Support Alliance had co-ordinated its efforts and concentrated all its support behind the Dilnot Commission’s report and its recommendations. The Government’s eventual approval of the report highlights that the people left standing when “it felt dead in the water” had been very important, but she felt that post-Commission the experience and expertise of those involved could have been better used.

Paul Burstow MP started by explaining that he had been around the issues of social care for fifteen years while in opposition, and whilst it had always been in the ‘to-do’ drawer of government, it had never been properly confronted because of its complexity. Therefore, the Commission had needed "big brains" on finance and economics, to consider innovative payment options, and insight into both the sector and Whitehall. The passage of the report was then helped by the disruptive influence of coalition politics on the systems of Government.

He drew attention to some of the issues that will affect the implementation of the recommendations, for example, that the new procedures must come into effect in all local authorities at the same time and to the same standard. However, he also identified some of the successes of the Commission, including that Government has now accepted that the state has some financial obligation for social care, and that the proposal will bring people into contact with their local authority, meaning that conversations about aging better can occur within the community.

Questions from the audience covered a number of issues, including:

• the appropriateness of this Commission’s working model for others
• the need for a political campaign, as well as a social campaign, amongst parties to raise awareness
• how the structures of local authorities were thought about in the Commission
• the language used by the Commission, and others, to frame their arguments.