Just how much you need to have in savings to risk losing your home if you get ill

Who looks after those who cannot look after themselves? And who pays for it?

These questions have faced governments of all colours for decades but all have ducked the issue.

Social care is arguably the greatest issue facing Britain right now so the public would rightly expect there to be a plan.

But sadly that is not the case. Instead there is a lot of confusion, worry and some suggestions, but certainly no coherent strategy. And time is fast running out.

Across 30 years there have been no fewer than two government commissions, one government-commissioned review, three independent commissions, five white papers and 14 parliamentary committee inquiries on social care reform. And yet the one thing we are yet to see is any meaningful action on an issue that affects, or will affect, every one of us.

A good place to start in understanding why there has been such intransigence, and with it deep frustration at the ministerial inertia, is Sir Andrew Dilnot, perhaps Britain’s most authoritative figure on social care.

In June 2010, he was asked by the Government to chair the Commission on Funding of Care and Support which published its findings in 2011. It recommended limiting individuals’ contribution to social care costs at £35,000, after which the state would pay. His report was welcomed by then Health Secretary Andrew Lansley, and both David Cameron and Ed Miliband called for cross-party talks on the issue.

Fast forward 15 years and without any hint of irony last month the very same man appeared before a Parliamentary inquiry entitled Adult Social Care Reform: The Cost of Inaction.

That itself would be funny, except what he had to say was anything but.

In a blistering evisceration of the three-decade malaise, he said it was “blindingly bleeding obvious” that something should be done in an area which, bafflingly, remains “pretty invisible”.

Sir Andrew was born in Swansea, South Wales, where they are known to call a spade a spade. And his language might have been a little fruitier if he were talking anywhere other than Commons probe.

But what he was trying to get across is that while social care is a critically important issue it is most certainly not a sexy subject, and that is part of the reason it fails to get the traction it should, both in the corridors of power and among the public.

Sometimes the truth isn’t alluring. In this case, it’s downright sobering.

Britain’s bloated welfare state is based on National Insurance contributions, yet no money is set aside to fund social care.

It means treatment for cancer is free but the cost of social care, which includes help for conditions like Alzheimer’s, are not. In England anyone with assets over £23,250 has to cough up.

Depressingly, whether through ignorance or unawareness, there remains a prevailing assumption care will be available when and where it is needed. The stone cold reality is nothing could be further from the truth.

In no greater example of the unfairness of life’s lottery, those unfortunate enough to be struck down with dementia, but with modest assets, receive no state assistance and are forced to pay eye-watering sums for care, often from life savings or house sales, denying loved ones an inheritance. To add insult to injury, they are forced to contribute towards the bills of others with no savings.

Meanwhile, those struck down with cancer, but with vast assets, receive top-quality taxpayer-funded NHS care.

The facts are startling. The social care sector employs around 1.6 million people but there are now 152,000 vacancies, a rate of almost 10%.

April’s National Insurance and wage hikes are likely to be the final nail in the coffin for many smaller, independent providers who shoulder the burden of looking after those unable to help themselves, placed there by cash-strapped local councils struggling under the weight of increasing demand.

The catastrophe unfolding before our eyes comes as some claim successive governments have hidden the true scale of the crisis from the public.

It is now generally accepted there is a £9 billion deficit between what is available and what is needed to meet the full cost of looking after an ageing population with ever more complex needs.

Analysis by the Nuffield Trust suggests social care providers face a £2.8billion hit due to April’s National Insurance and wage increases.

Separately 22% of 1,180 providers recently polled by the Care Provider Alliance say they are planning to close, 73% will refuse new referrals from councils or the NHS, 57% planned to hand back some contracts and 64% will make staff redundant.

Mike Padgham, Chair of The Independent Care Group which speaks for providers, told the Daily Express: “I think there is a danger the Government is sleepwalking into a very dangerous situation.

“I fear it seriously underestimated the impact National Insurance and wage increases would have on a sector that has been brutally neglected for three decades.

“We have long argued the social care sector was teetering on the brink of collapse and feared it might just take one thing to tip it over the edge – we might just have reached that point.

“While government after government have been able to ignore the quiet erosion of the sector through the loss of smaller providers over the years, they will not be able to turn a deaf ear on an avalanche of closures.”

Removing social care businesses from the looming NI hammer blow would be a sensible and pragmatic approach. That’s why it won’t happen.

But that’s only a small part of a much wider problem. Alarm bells have been sounded for years, yet the warnings have not been heeded. Successive governments have failed to rise to the challenge with the decades peppered with fine words, official reviews and even legislation, but no meaningful reform. In short, politicians of all colours have consistently kicked the can down the road.

It’s why the announcement of yet another commission on social care, this time overseen by Crossbench Peer Louise Casey, received barely a whimper, not least because its final recommendations will not be known until 2028.

And you can see why there has been a collective shrug of the shoulders. Just a year later, at the end of this Parliament, there will be 14.6 million people aged 65 and over in the UK – an 11% increase on the 13.2 million today.

It means that it will not be until after the next General Election at the earliest that any useful strategy to address this enormous issue will be known. And by then it will have only intensified. You’re starting to get the message here – it’s another hoof into the long grass, by which time it will be someone else’s problem.

One radical idea to help soften the hammer blow of old age is the creation of a new social care tax.

Some argue that so-called Social Insurance contributions – paid by workers and retirees – would be a fair and equitable way, perhaps the only realistic way, of paying for a basic level of state-provided care with savings, ISAs or pension cash used by those with means to upgrade to gold standard packages in the same way as pensions are topped up.

It would also go some way to giving social care parity of esteem with the NHS.

Sexy? Most certainly not. Radical, undeniably.

The shameful political neglect of the social care system by politicians of all colours means far too many people go without the care they desperately need, a shattered workforce is underpaid and undervalued, and as is the case in so many other areas of life the resulting burden weighs heavily on an army of unpaid carers, more often that not family and friends.

That the magnitude of addressing social care has yet to resonate with neither politicians nor the public is a stain on Britain. And not having any money, no less a plan, for how to deal with the tsunami heading our way could end up being one of the biggest policy failures of modern times.

Giles Sheldrick is the Chief Reporter for the Daily Express.