The 1999 Royal Commission is not the first of its kind. More than a century ago there was a Royal Co...
The 1999 Royal Commission is not the first of its kind. More than a century ago there was a Royal Commission on the Aged Poor. Chris Ellicott reviews the reports and sees how far the debate has moved on
In January 1893, Queen Victoria set up the Royal Commission on the Aged Poor. The Commission reported back two years later in February 1895.
One of the commissioners was the Prince of Wales, later Edward VII. By the time they reported back he felt unable to sign its report since "the subject has now to a considerable extent become one of party controversy." There were also 12 separate 'memoranda' of dissent on particular points in the main report.
Given the astonishing silence which has followed Frank Dobson's call for a 'period of informed debate', most of
us would probably agree that party controversy is just what is needed.
What strikes most when reading through the text of the report from the 1895 Royal Commission is not the differences between then and now, but the similarities. These were apparent in the problems which people foresaw and in the attitudes of witnesses before the 1895 Commission. How many of these comments would attract nods of approval today?
Commission past
When the 1895 Royal Commission was sitting, England was still firmly in the grip of the process of industrialisation, while its country areas were 'rural' to an extent we cannot now imagine. There was no National Health Service, no old age pensions, and life expectancy was only around 45 for a man and 49 for a woman. Help for those who needed it came via the Poor Law and its institutions.
The brief of the Commission was to consider 'whether any alterations in the system of Poor Law relief are desirable, in the case of persons whose destitution is occasioned by incapacity for work resulting from old age, or whether assistance could otherwise be afforded in those cases.'
In these words there is a clear assumption that a person should not become destitute just because of old age despite the lack of an old age pension - they should only become destitute in old age if they are unable to work as well. So while the parallel with the recent Royal Commission is not exact, it is much closer than it might seem at first sight.
In the census of 1891 in England and Wales, there was a total of 402,000 paupers aged over 65 who accounted for 5.4% of the population and 29.3% of the over 65s. 40% of paupers were in workhouses and other institutions, but the majority received help at home.
At the same time the total number of 'notable bodied poor' was some 351,000 - only 10% of paupers were 'able bodied', simply reflecting the 'work till you drop' principle which did not recognise the retirement concept that we understand today. And while there were not many over 80s at that time (149,000 in 1891) 30% of them were paupers, the highest proportion of any age group - so the old poor are not a new phenomenon.
The total cost of providing Poor Law relief in 1892 was just £8,850,000. In today's money this is around £500m, so the cost of the Welfare State was quite an item even in the days before it was invented.
How does this compare with the 1999 Royal Commission? Here are some extracts from the report of the original Royal Commission and how they could be interpreted today.
The State's responsibility
l It would be unjust that State assistance be withheld from those who could not contribute to a pension scheme, while given to those in regular employment and able to make contributionsÉ the State has to provide a safety net.
l The control of the vast sums that will be accumulated (in a funded scheme) would give the government of the day
a dangerously preponderating influence on the money marketÉ why funded schemes might not be a good idea.
l The pension should as nearly as possible the equivalent of the inclusive cost of the maintenance in a poor law establishment of an aged pauperÉ not quite how much the old age pension is in 1999.
l In the absence of temporary provisions the scheme would have no direct effect as regards the aged until the pensions would begin to be payableÉ any scheme has to solve short-term problems as well as long-term ones.
Who should receive the care and who should pay for it?
l That the grant should be universal and could be claimed by all would no doubt distinguish the scheme from a gigantic measure of outdoor reliefÉ if everyone gets it, then it is not charity, it is an entitlement; and those who need it will not be put off asking for it.
l If the scheme were ever to come into operation, a general outcry would be raised against the payment of such an annuity to persons with even a moderate competenceÉ the opposite view, you should not be giving money to those who can provide for themselves.
l If the Imperial charge were adjusted to fall entirely on classes reaping no benefit we think this alone would be fatal to many of the proposalsÉ Frank Field's point of view.
Local authorities
l The commissioners did not consider that there would be any difficulty or danger in entrusting the administration of the scheme to a local authority, and making them judges of incapacity to work, while throwing the cost on Imperial taxationÉ how wrong can you be?
l A man who had saved a little would be in the better position of having the power of disposing of his propertyÉ asset deprivation was on the authorities' minds even then.
And their opinion on means testing?
l The interest of any savings would be deducted from the amount of the pensionÉ means testing rules were just as harsh even then.
What about informal care?
l There is also the probability that the sense of responsibility of relatives would be seriously underminedÉ people would stop caring for their families - however, in 1999 we still have seven million carers.
Care at home vs care in a home
l Except in crowded urban areas, the great majority of the aged poor in receipt of relief are given outdoor reliefÉ most people being looked after got care at home.
l Indoor relief (not in the person's own home) should be given only where the person is so old and helpless that they ought not to be left to live by themselves, or if it is not right that they should continue to live under such unwholesome conditionsÉ care at home if possible.
And the conclusions of the 1895 Royal Commission? After examining and rejecting a number of schemes on cost grounds, some of which would have provided all relief free of charge, and some of which involved private/public insurance schemes, the principal recommendation was that no change was necessary in the system as it existed at the time. However, the Commission did go on to recommend that:
l There should be greater discrimination in the application of relief for people in their own homes (outdoor relief) in favour of 'the respectable who become destitute, and against 'those whose destitution is the consequence of their own misconduct'.
l The amount of relief given to an individual should be enough to meet their needs.
l The system for providing relief needed more staff as it was overstretched and under-resourced.
l There should be no change in the law (which was basically an Elizabethan statute) which required children who were able to and could afford to do so to support aged parents in need.
l The Post Office and friendly societies should make more easily available 'endowment assurances' for securing lump sums at given ages, as people prefer these to 'deferred annuities' which provide only an income for life from a fixed age.
And finally the old Commission concluded that the debate should continue. What prophetic words those were. The long term care debate has lasted more than 100 years and there is still no end in sight. It is time the Government gave us a real reason to celebrate - a solution.
Chris Ellicott is technical manager at PPP lifetime care
