Elections aren’t just fights between the parties over policy. They also include conspiracies of silence where neither side will benefit from talking that much about an issue. Social care is one of those toxic problems: it is a key driver of inefficiency in the NHS, and should have been reformed three decades ago. It is also expensive, complicated and little-understood by voters, who resent any iteration of reform because all involve someone shelling out money when many people think it is free currently (it is not), or that it somehow should be.
When Wes Streeting and Keir Starmer launched their big NHS plans last week, they failed to mention social care reform at all
This morning, Business and Equalities Minister Kemi Badenoch was quizzed on her party’s plans to reform social care. She didn’t take kindly to being asked about this during her appearance on Times Radio. Initially, she explained that ‘it is one of those issues where there is no perfect outcome’, reminding listeners that when Theresa May tried to tackle the subject in the 2017 election, ‘people responded very negatively to it’. Pressed on it, she said: ‘What people want is a plan and we have laid out a plan and the plan is basically funding, we have laid out a plan.’
She then said ‘the plan we have talked about for the NHS, it is not just about social care, we talked about a long-term workforce plan.’ When the presenter kept going with the social care questions, asking what this plan actually was, Badenoch objected, saying this was a matter for the Health Secretary: ‘You know that I’m not the Health Secretary…I’ve given you an overall status of where we are in social care. If you want to go into detail, you need to speak to the Health Minister, or you can ask me about Business. You can ask me about Equalities. And that’s what – you’ve brought me on your show under false pretences.’
Badenoch had come on to speak about her party’s proposed reform of the Equality Act so that sex is defined as ‘biological sex’. This is a hugely complex and emotive area, too, but it just happens to be a topic the Tories are happy to talk about because they think it makes Labour deeply uncomfortable given the splits over transgender rights within Keir Starmer’s party. So the hot button issue is OK to talk about, but not the other issue, which has been rumbling on for more than 30 years without a resolution.
Labour shadow ministers may not be as direct as Badenoch in shutting down questions about social care: she has an unusual attitude to the media and scrutiny. But the Opposition does not want to talk about social care during this election campaign either, for precisely the reason Badenoch set out: voters react negatively to any reform proposals.
When May offered her prescription for social care in the 2017 election, she did so assuming that she would win a huge majority. The Conservatives do not think they are going to win at all, while Labour is doing everything it can to avoid being presumptuous and to minimise risk in this campaign. In 2017, Labour MPs who were expecting to lose their seats remarked privately to me that they didn’t think what May was proposing was the worst idea and that they actually respected her for facing up to one of the big issues of the time. But this was an election and they were about to lose their jobs, so they would of course go out onto the doorstep and brand this a ‘dementia tax’. Many of them held their seats unexpectedly because May did not sweep the country with a huge majority. Many of them are out campaigning today with the hope they will be in government in a few weeks’ time. None of them are talking about social care.
When Wes Streeting and Keir Starmer launched their big NHS plans last week, they failed to mention social care reform at all. So far, the party’s position seems to be the same as the one Starmer set out to me back in January 2023: full-scale reform of social care will be a second term issue. Both parties will have some kind of token reference to social care in their manifesto. Neither will highlight it, and neither will want to talk about it for any longer than they need to in interviews.
To get your way in politics, you first have to win, and so social care isn’t an election talking point. But the problem is that once parties win, they don’t tend to grapple with social care, even if, as Boris Johnson claimed when he won in 2019, you have an ‘oven-ready’ plan. There was no plan back then, or at least not one that Johnson was prepared to implement. But the past 30 years has offered a whole larder of options for the winner to pick up and get on with once they’re in power. The question is whether the conspiracy of silence will continue after the election, too.
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