- The problems of the current settlement for health and social care are systemic, in the commission's view. They stem from a lack of alignment in entitlements to care, between funding streams, and in organisation/commissioning of care.
- There is a problem of adequacy, with too little public money spent on social care and too much demanded of at a time of rising needs.
- The public has a poor understanding of the present system of social care. The current system is heavily dependent on unpaid carers and is inequitable, with shifting boundaries on entitlements.
- Greater life expectancy, an altered disease burden, and medical advances have all resulted in more people requiring health and social care.
When Lord Warner proposed a £10 monthly membership fee for the NHS, Liberal Democrats were quick to condemn him.
- Economic growth means that better health and social care are not unaffordable. But intense short-term pressures and long-term changes mean hard choices will need to be made on funding.
That was my instinct too, but if we rule such measures out, how are we going to meet these demands for better funding for health and social care?
The most important tenet of the government of which we form part is the need for austerity, and these days the call for more tax cuts seems to be the most important Lib Dem policy.
Quite how these two fit together is an interesting question for debate, but however you reconcile them it is clear the Lib Dems will have trouble finding extra money for health and social care. Economic growth would ease the pressure, but relying solely upon it sounds a rather Labour way of dodging the question.
So how will we do it? Or have we given up trying.