Long-term care for older people

Professor Jon Glasby

Image from istock: Give Me Your Hand

Image from istock: Give Me Your Hand

As part of the ‘saving humans’ theme, a number of contributions from across the University are likely to focus on the causes and implications of climate change – potentially one of the most significant current and future threats we face. At first glance, all this feels a long way away from the day-to-day reality of front-line health and social care (which is our area of specialism here at the Health Services Management Centre). And yet, there’s an unusual but uncanny similarity between debates on climate change and current controversies around the future funding of long-term care for older people…

This probably sounds odd initially – but different Ministers and governments over time have started to look for solutions to the funding debate and shied away when things got too difficult. Although it’s often neglected as a policy issue, the quality and funding of services for older people is a major social issue that touches us all in different ways and at different times of our life. Yet devising a solution to such a complex, embedded series of problems will inevitably be long-term, controversial and unpopular. Crucially, the benefits won’t be felt for many years – so a current political leader will have to take significant pain and criticism for unpopular measures that don’t pay dividends until much later (when someone else gets the credit). Faced with a potential backlash to any of the solutions that might actually work and with an election looming, it’s tempting to kick the issue into the long grass and leave it to the next person to sort out.

For me, this is precisely like the climate change debate. Deep down, many of us as private individuals know there’s something serious at stake here and that something fundamental will need to change. But it’s so long-term and so difficult that it’s easier just to put it off to tomorrow and assume that someone else will sort it out…

In long-term care, we’ve seen this time and time again – from New Labour’s failure to implement the central recommendations of the Royal Commission on Long-term Care, the lack of a response to Sir Derek Wanless’s review, the failure to implement plans for a ‘national care service’ and what many now feel is a watering down of the proposals of the most recent Dilnot Review. And yet the issues at stake are serious and far-reaching. We have a health and social care system designed with 1940s society and demography in mind which has felt increasingly unfit for purpose over a number of years, and is now ready to burst at the seams. Putting this off until another day simply isn’t a credible response – but it wouldn’t surprise me if – like climate change – this is exactly what we do (again)…

Jon Glasby is Director of the Health Services Management Centre (HSMC) and Professor of Health and Social Care. 

In 2010, HSMC worked with Downing Street and the Department of Health to review the future funding and reform of adult social care. Our subsequent report was launched by the Prime Minister and was a key plank of the government’s subsequent White Paper – see:

Glasby, J., Ham, C., Littlechild, R. and McKay, S. (2010) The case for social care reform – the wider economic and social benefits (for the Department of Health/Downing Street). Birmingham, Health Services Management Centre/Institute of Applied Social Studies

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