The crisis Britain’s politicians are too scared to discuss

EASTBOURNE, ENGLAND — “They used to say Eastbourne was the place to go to die,” sighs a woman walking along the town’s main street. 

A classic British seaside town, Eastbourne — 70 miles south of London, perched on the southern tip of Britain — is both beautiful and run down. White cliffs line the seafront, a tired arcade juts out upon the pier. 

Eastbourne’s population is — there’s no sugarcoating it — old.

Around 25 percent of residents are aged 65 or over — far higher than the national average of 18.6 percent. In Eastbourne and the wider East Sussex area there are an estimated 69,000 unpaid carers looking after those in need. That means a national crisis which has long gripped the U.K. is keenly felt in this quiet, sun-struck corner of the south coast. 

Britain’s adult social care sector has been in turmoil for as long as most can remember — soaring numbers of elderly people and chronic underfunding posing a public policy challenge met with a distinct lack of answers by several generations of politicians.

In March, the House of Commons Public Accounts Committee accused the current Conservative government of bringing the care sector “to its knees,” citing severe staffing shortages, rising waiting lists and uncertain finances.

The Nuffield Trust, an independent health think tank, has said “consistent underfunding” means publicly-funded care for the nation’s elderly population is now “limited to those with the lowest means and highest needs.” An estimated 1.6 million elderly people in England have unmet care needs, and the list is growing fast.

Yet the issue has barely been mentioned by either of Britain’s two main political parties in the current election campaign.

“‘We have to turn people away”

Eastbourne’s branch of the Age Concern charity is a welcoming space. There’s a cafe where a group of pensioners meet over cake. Posters adorn the walls offering daily activities, benefit support, nail care. A receptionist chats to one of the elderly visitors about a colleague’s holiday. A community exists within these four walls. 

The main business of the charity is providing at-home care for the elderly. Director Nicola Funnell says 80 percent of its service users now pay for their own care, with just 20 percent funded by the local authorities. This is a significant shift from previous years, says Funnell, who notes the charity has taken in no new clients by the council at all funded this year. 

Eastbourne is not a rich area, and most of the clients served by Age Concern aren’t wealthy. But often they have little choice but to pay for their own care. 

“The financial assessment [of an individual’s circumstances] from East Sussex Council is taking so long that people are coming forward to pay for themself,” Funnell says. You can’t wait for bureaucracy when your loved one can’t dress or feed themself, or manage their own hygiene. “Most of them are doing it because they really have to.”

The Labour Party has pledged to “get a grip” on soaring NHS waiting lists. | Adrian Dennis/Getty Images

Even if potential clients can afford the services, that doesn’t mean care will be available. “We have to do a sort of a balancing act. I don’t have enough carers to take on the care that’s coming in, so we have to turn people away,” Funnell says. 

In a statement, East Sussex Council said it has “a number of primary and secondary providers holding contracts for home care provision,” and that it strives to ensure residents “receive the appropriate support as quickly as possible.”

Political failure

The Labour Party, which opinion polls say is on track for a landslide win on July 4, has pledged to “get a grip” on soaring NHS waiting lists and vowed to introduce a National Care Service offering consistency of care. Better pay conditions for carers have been hinted at, as well as root and branch reform of the entire sector.

But Labour’s promises fall well short of a concrete plan. The Nuffield Trust described the party’s pledges as “commendable ambitions” which are “overshadowed by the lack of a costed plan for social care.” The Institute for Fiscal Studies, a respected non-partisan think tank, said Labour had provided “next to no detail on how or when these [reforms] would be implemented, or what final form they would take.”

Pushed on this during the campaign, Shadow Health Secretary Wes Streeting admitted to the BBC’s Laura Kuenessberg that Labour’s plans fall short of what he’d hoped.

“On social care, I would have wanted the manifesto to be more ambitious,” Streeting said. “But to get policies in the manifesto you had to run the gauntlet of answering two fundamental question: Can we keep this promise? And can the country afford this promise?” Streeting said he hoped the incoming Labour government would generate “tens of millions of pounds” to put into the sector.

For its part, the Conservative manifesto has vague promises of “a high-quality and sustainable social care system,” with a “multi-year funding settlement to support social care” for local authorities and a pledge to “attract and retain a high-quality care workforce.” 

The warm words echo Boris Johnson’s infamous ambitious but never-enacted 2019 social care plan, leading the party to run straight into the brick wall criticism during the election campaign of “why didn’t you do this before?”

As with Labour’s offering, the plan is also criticized as falling short. The Nuffield Trust said the Tory manifesto does not deliver Rishi Sunak’s promised “bold action.”

Historically, pledges for major social care reform have not worked well for the Conservatives.

During the 2017 election campaign, then-PM Theresa May came out with a startling and unexpected promised to overhaul the entire sector to put it on a sustainable footing. But her chosen funding model, which included the value of a person’s house in assessing eligibility, proved violently unpopular, forcing her to U-turn within days. Voters were so angry she lost her parliamentary majority.

Since then, social care has been a sticky, better-to-avoid subject for the major political parties. 

Aside from the Liberal Democrats.

The Lib Dem masterplan

At the 2019 and 2017 elections, the Lib Dems were staunchly considered the anti-Brexit party.

But now, the small centrist grouping — which has only a handful of Britain’s 650 MPs — is the only national party putting social care at the heart of its manifesto. And it appears to be cutting through to the electorate. 

Lib Dem Leader Ed Davey is a carer to his disabled son John and to wife Emily, who has MS. He also cared for his mother while still a teenager, and after the death of both parents, his grandmother. Early on in the election campaign, Davey took part in a breakthrough interview with ITV News where he showcased his life juggling caring and work, tearing up as he spoke about the pressures of his competing roles.

Soaring numbers of elderly people and chronic underfunding posing a public policy challenge met with a distinct lack of answers by several generations of politicians. | Darren Staples/Getty Images

“I was at an event where there were quite a lot of people there who I know are typical Conservative supporters,” said the Lib Dems’ candidate in Eastbourne, Josh Babarinde.“Two folks came up to me and said, ‘I saw your leader’s video, and I thought, what a guy.’

“Even our own volunteers, who are already predisposed to liking the leader of the party, were moved. It’s rare for a politician to showcase so much of themselves.”

The honesty around a typically taboo subject broke new ground for the Lib Dems. Social care has become one of the main themes of the party’s campaign. They’ve pledged to introduce free personal care, a National Care Agency, and to create a cross-party commission on social care funding.

Seventy-five miles north west of Eastbourne in Surrey Heath, a traditional Conservative stronghold which polls suggest is now within the grasp of the Lib Dems, the issue is just as pertinent. 

“It comes up all the time,” said Lib Dem candidate Al Pinkerton. The picture he paints here translates to many constituencies across the U.K — an aging population of baby boomers who “can’t access care homes because there aren’t enough,” and who “can’t access social care” due to cost or lack of staff. The problems are hyper-local but at the same time resonate across the land.

And the Lib Dems have cornered the hyper-local market. Both Pinkerton and Babarinde walk down the street with people greeting them as if they are old friends, reeling off campaign lines written on much-circulated leaflets. In a way, the party has become the nice guys of politics, knowing the names of locals, sharing their stories, and vowing to fix a crisis of ostensibly soft issues skirted around by the major parties.

Unconvinced

But not everyone is convinced.

The Nuffield Trust said the Liberal Democrats were “right to put the desperate need to improve social care” as a priority — but raised concern about “adequate funding.” The IFS said there was not an “overall spending plan” to back up the proposals.

The campaign seems to be working on the doorstep, though all positive comments come amid worn-out tones.

“I’m voting for the Lib Dems,” one woman said, shutting down the Conservative candidate as he canvassed in Surrey Heath. “But I’m a bit disenchanted in it all, really.”

“I want to vote for the Liberal Democrats,” said another woman in Eastbourne, “but I worry it’s a wasted vote.”

Maybe not. The Liberal Democrats’ poll numbers have been rising through the campaign, with one MRP poll from Savanta published Thursday putting the party on course to gain 50 of the U.K. parliament’s 650 seats, putting them just three behind the Conservatives.

Back on Eastbourne’s high street, a man sums up the mood best when asked who he will vote for. “Guy Fawkes springs to mind.”