Tax hikes are the only way to meet the challenge of a broken care system

There is no challenge less suited to solution by the British political system than social care for the elderly, infirm and some people with disabilities.

It is, by definition, long term; where politicians’ horizons are notoriously short. It demands a bipartisan consensus, while Westminster politics favours division and opposition for its own sake. It might work better under a rational system of personal taxation, while Britain persists with its inconsistent and archaic twin systems of income tax and national insurance. Above all, it demands political courage, and that’s never been a commodity in plentiful supply.

There are signs that the sheer stress on local authorities and the NHS may be about to force some change. The briefings and counter briefings about prospective tax hikes from Whitehall are at least an indication that debate is under way, and something may arise from that in the chancellor’s autumn statement, due on 27 October, with rumours of a prime ministerial statement of intent as early as next week.

Some two years after Boris Johnson made a characteristically rash promise to “fix” the care system, it remains resolutely unfixed.

Depending on the nature of illness in old age, one citizen may end up losing their home and most of their savings, while another is taken care of, free of charge. Aside from that are well-recognised questions about the quality of care.

Since the Dilnot report of 2011, virtually nothing has been done except the administrative gimmick of rebranding the now Department of Health and Social Care, and the Treasury, periodically. Stumping up a few billions to patch up the system.

This was never going to be adequate to the huge demographic challenge of an ageing population spending more of its later twilight years in poor health. Yet whenever detailed proposals come forward, such as those in the Dilnot report or even Theresa May’s plan in the 2015 election, they are quickly unpopular, because there are always losers.

The electorate seem to lack the maturity to realise that someone somewhere has to pay for all the homes and nurses, a task made even more difficult by Covid and Brexit.

The latest reason for the failure to “fix” care is not hard to identify; Mr Johnson’s rash promise in the 2019 Conservative manifesto not to raise income tax or national insurance rates.

Such crude guarantees never take account of “events”, and show the democratic process at its most juvenile, because wars, economic crises and indeed pandemics can always disrupt even the most sincerely made pledge. Besides, the care crisis is hardly something that no one saw coming.

To pretend, as the government has, that it can be resolved without radical fiscal action is simply another example of the disease of “cakeism”. In any case, the outlines of a consensus, at least within the Conservative government, are starting to emerge. In return for a cap on the amount individuals will need to contribute to their own care – something like £60,000 to £100,000 – there will be an increase in personal taxation, however it is labelled.

It will break the spirit, if not the letter, of the 2019 manifesto promises. The parameters are in fact relatively narrow: a 1 per cent levy on incomes apparently favoured by the prime minister, 1.25 per cent by the chancellor and 2 per cent by the secretary of state for health and social care.

Some other changes, including eroding the effect of the triple lock on pensions, should be enough to find the £10bn-plus a year needed to keep the old and infirm from destitution, and bring some fairness to the system.

As might be expected, Conservative backbenchers will cry betrayal and will affect horror at the prudent home owner having to give up such a slice of their wealth; and Labour and the other opposition parties will make mischief whatever the government comes up with.

It is, though, incumbent on them to come up with an alternative. They will not be able to, and that will be Mr Johnson’s strongest argument for getting his reforms through.