Guest blog by Stephen Burke

Ten years since the Dilnot commission published its report is a grim anniversary and a grim reminder of a terrible decade for older and disabled people and their families.

Not only has there been no progress in reforming (let alone improving) care, we have gone backwards since 2011. Fewer people can access care despite growing needs and more families are bearing the cost of care or caring themselves, while those who do get care often complain about its quality and reliability.

So what went wrong? In essence the government in 2010 asked the Dilnot commission the wrong question: how can we prevent people having to sell their home to pay for care? Not surprisingly the answer – primarily a cap on the cost of care – failed to address the key problem of underfunding.

The cap on care costs is widely misunderstood and partly because it would make an already complex system even more so. It would not bring new money into the care system, it would just substitute private spending with public funding, thereby benefiting wealthier families in the main. And many poorer families would still have to sell their home to fund the accommodation costs of residential care.

So the Treasury should be congratulated for stopping the implementation of the Dilnot cap, even though it had passed through Parliament.

But ten years on, if the media is to be believed, the government is still fixated with the idea of a cap on care costs. If only life was that simple.

As many organisations now agree, the crucial first task should be to set a 21st century vision for social care and how it could help people lead the lives they want. Together with the principles and plan for how such a vision could be delivered – from universality, fairness and sustainability to personalised care, a valued workforce and support for families.

Then we could determine the resources required to deliver such a vision. The vision must be long term, bold and ambitious and the funding must match the vision.

That is how we would fund better education, better defence and better health services: first agree what we need and then find the funding to make it happen.

Sadly the care debate falters on the rocks of how we should pay for it. Instead the government should ask and answer the right questions: what kind of care and support do older and disabled people and their families need and want? And what are the costs and benefits of implementing this new system?

A rigorous cost-benefit analysis of moving towards a universal care system would demonstrate why care is so fundamental to the future prosperity and social cohesion of this country. And that without radical action over the long term, Britain will pay the price for many generations to come.

The next six months are crucial. The Chancellor and the new Secretary of State for Health and Social Care are well placed to ensure that reforming care makes economic and social sense.