The sixth giant

We need another giant step to tackle care and support, says Ray Jones
A disabled woman
"The government and the other major political parties are heavily committed to disabled and older people having more choice and control in their lives." Photograph: Don Hammond/ Design Pics Inc/ Rex Features

The welfare state was built to tackle the "five giants" of squalor, sickness, ignorance, idleness and want. These were concerns about basic human needs brought on by the economic depression of the 1930s.

What was not contained in the original 1942 Beveridge report was a focus on people living meaningful lives, with ambition and aspiration, beyond the baseline of basic standards. Welfare was about safety, survival and security, not about what we might now call self-actualisation.

This is the "sixth giant" and a good example is the government's Every Child Matters policy, which emphasises that all children and young people should be able to achieve, to have ambition and to be active contributing citizens. Similar values are enshrined in its policies for people with a learning disability, and disabled and older people.

So what should this mean for policy? First, we must ditch the Poor Law legacies of postcode lotteries and eligibility criteria, and move to a nationally consistent system of providing help so that regardless of location the same level of assistance is provided. Moving around the country, for example, to be nearer to family and friends, would not be so daunting if the fear of help being withdrawn was not an issue.

Second, create a system where the care needed determines the level of assistance, rather than the amount of money left half way through a council's financial year. This requires moving away from cash-capped budgets to an entitlement to funding based on need.

Third, replace the current wasteful arrangement of 150 councils in England (and 22 in Wales and 32 in Scotland) all inventing their own policies to determine who gets help.

Fourth, spend less time rationing and restricting assistance, and more time helping disabled and older people achieve their ambitions. Councils should be opportunity creators; social workers should be advocates and advisers to those who need assistance.

It is not necessary to invent a wheel to deliver this radical new care and support system. The government and the other major political parties are heavily committed to disabled and older people having more choice and control in their lives, and with a major say about how money for their help will be spent. But the ways of making this happen, ranging from direct payments of cash by local councils to "individual budgets", have become too complex and wasteful.

A more consistent, economical and fairer way to get money to disabled and older people would be through the national insurance and social security systems. This already happens for attendance allowance, disability living allowance and other invalidity benefits. This should be the foundation of the radical reform that is necessary for care and support, putting people who receive state funding and those who are self-funding in the same position of having control over finances. There is, however, danger on the horizon. The Local Government Association is arguing that rights-based national insurance disability benefits should be allocated to local councils and be wrapped up in councils' discretionary, cash-strapped social care budgets. This would be a retrograde step, taking security and rights away from people who need money to get the help they need.

Now is the time to put the Poor Law to bed, and to build on Beveridge - not by turning the clock back or by tinkering, but by tailoring a new framework for assisting disabled and older people.
