The Dilnot Commission

Yesterday I was contacted by the Guardian asking if I would like to do a piece for their Comment is free column. Sadly as you'll know I was out having a romantic lunch with my Valentine - not sad, I hasten to add, because of enjoying Jane's company, but merely because by the time I'd returned to my emails they'd found another blogger to write it instead! Fair enough: speed is all in the world of daily newspapers.

They'd wanted a piece following on from a crie de coeur piece headlined

'Life not worth living' for disabled people facing benefit cuts

Campaigners say government plans to end automatic right to state support for independent living is causing many to despair . Read full article                                                                                        

I was surprised on reading the article to discover that it was about the government's Commission on Funding for Care and Support, the Dilnot Commission for short, after its chairman, Andrew Dilnot, the former head of the IFS (Institute for Fiscal Studies), and that the consultation period was ending this week. Oh well, I thought, because by now my brain was running on overdrive, I can at least make a submission to the commission. So I was even more surprised on going to the Commission's website to discover, at the end of 22 pages, that in fact the deadline for submissions was midnight on 31st January. "Darnit!" I thought. "I don't remember that ever being publicised." So I googled it, and I couldn't find a mention of the deadline, nor even an invitation for submissions, in the news media. Clearly the disability and aged groups had been contacted. But were they really interested in what individuals thought? Not everyone is represented by a group. And ultimately, one hopes, it's about the care and support of individuals.

It so happens that we know Andrew Dilnot. In fact one of our children had digs at the top of their house once. I can't think of anyone in whom I'd have more faith to head up that commission - brilliant, humane and understanding of needs. I gave a cheer when I heard he'd been appointed chairman. But his task is immense. Originally the government gave them a fourfold remit: sustainability, fairness, choice and affordability. The Commission negotiated a fifth: ease of use. If you've been following Michael Sandel's excellent series on Justice on BBC4, you'll recognise that these are all utilitarian considerations. Even "fairness" is defined as "for individuals, families, carers, and the wider society". In other words there's a calculus to be made between the stakeholders' interest and "the wider society", reinforced in two other criteria, sustainability and affordability. Which of course are very necessary considerations for the "state" to make. But there's a question to be asked first - which is, where do we place our priority in deciding what we can afford? Ultimately where's our value-base? What do we hold as non-negotiably good in our society? That is what should determine our spending/taxation priorities.

That does mean asking some very hard questions. Of course it does. For example, is the free market economy more important than the compassionate society? Is subsidising high art a priority? Free museum entry? Financing high profile sports events... Tax breaks for billionaires, hedge-fund managers... Protected pensions for MPs...? What does fairness mean? Does it mean everyone being treated the same by the state? No winter-fuel allowances and free bus passes for the elderly? No child-benefit for those feckless enough to have babies? No subsidised bars for MPs? No allowances for the disabled?

The oldest law code I'm familiar with sets the highest priority on protecting the vulnerable: "Cursed be anyone who perverts the justice due to the sojourner (alien), the fatherless, and the widow" (Deuteronomy from the Bible). "You judge a country, and its institutions, by the way it deals with the most vulnerable - hard to argue with that," said John Humphrys on the Today programme this morning. He was introducing a discussion about the report of the Health Service Ombudsman on bad examples of care for the elderly in the NHS. Later, Professor Raymond Tallis, once of Manchester University, warned against the business model that had permeated the caring professions, so that "people only value the things that can be counted". He went on to make this point, "There's a problem more broadly in society. What do we value in society? We value glamour. What is the least glamorous thing to do, but what is the most deeply important thing to do? It is actually hands-on care. I think that society at large devalues hands-on care, and I think that is another implicit pressure." I suspect I disagree with the professor on some things, but here I reckon he's on the mark.

"The most deeply important thing to do" ... is actually hands-on care. That's the opposite of letting the vulnerable sink or swim, while the rest of us in SS Great Britain head for secure financial ground, eventually. It's not hauling up the lifeboats and saving the life-rafts in case we might need them later. Neither is it thanking God that we have our own little (or considerable) life-rafts set aside should the worst ever happen to us. "You judge a country... by the way it deals with the most vulnerable." Let's not argue with that. And, Andrew, should you happen to be reading this, could you just make that the starting place for your policy-making?