>Areas with poor, old populations can never pay their way.

The root of the issue is that this area is now the country. Giving all old people the labor necessary to support them in old age was easier when the ratio of working people to non working people was much higher, in conjunction with old people not living as long.

Turn that population pyramid upside down due to drastically reduced birthrates and medical technology allowing people to live longer, and you get the current situation.

You say that like it's an imperative but it's not. This is a choice.

Through the government we elected, we choose to starve social care. We choose to starve education and so many other public services.

Yes, our age profile made it more expensive, but so what? We choose to underfund it.

It's actually through the local governments, many of which are Labour yet have the same issue.

Root cause: the law says to raise local taxes beyond a certain amount councils must hold a referendum. They systematically refuse to do this because they know they will lose.

Voters by and large think local councils are wasteful and don't really need more money. There's also another issue: some local councils especially in the North have a history of deliberately cutting front line services whilst e.g. expanding the central bureaucracy, because they know they can blame the Tories for not giving them "enough" money and the voters will fall for it. The councils could raise taxes, or rebalance spending, but that wouldn't energize their base.

Well I suggest you visit Norfolk. Councils have sold off their long-held land to developers, dumped their investments to their mates, stripped down services and tendered the rest. Serco does everything.

Save the odd blip, Norfolk is as blue as it gets. Interestingly they also blame central government.

And local tax raising is pretty blunt. How much your house would have been worth in April 1991, if you're working. High-retirement or high-unemployment areas usually have lower rates, and much lower incomes, while needing more than rich areas.

Yes, I said "many of which are Labour yet have the same issue" i.e. it's an issue with local governments of all stripes. There's a culture of spending more than tax levels allow then expecting central government to make up the difference.

State provisioned social care is not starved:

https://ourworldindata.org/grapher/social-spending-oecd-long...

The burden of providing social care has increasingly been transferred from individual families, to the centralized state.

Looking at cash is a poor indicator for what's actually provided.

Social care is 12-16% less available now than it was a decade ago. https://www.nuffieldtrust.org.uk/resource/care-home-bed-avai...

On your second part, this study also shows a significant 25y fall in the number of 85yo+ who are in homes. We aren't increasingly relying on the state.

Saying something is starved means saying it's underfunded. The statistics show more funds being allocated to social welfare programs.

If those social welfare programs are mismanaging those funds, that's an entirely different argument than arguing it's "starved".

Your statistics show an actual fall in the past 10 years. It's worse than that because the true picture needs to factor in local government spending now.

If we pretend there's been steady investment, and imagine stable demand, the same thing can cost more than it did before.

But irl, budgets have collapsed, demand is soaring and costs have already risen and are about to explode due to fuel-driven inflation.

So no, starved on three counts. The baseline cost is deviating from the investment. And yes, there are many, many elements to why.

>>Your statistics show an actual fall in the past 10 years.

From 22.79% of GDP in 2010, to 21.49% in 2016 (the last year provided). This is after an increase from 10.44% to 1964 to 22.79% in 2010. The big picture is a massive multi-generational increase in social welfare spending, interspersed with tiny downward fluctuations over a small proportion of the years covered.

>>It's worse than that because the true picture needs to factor in local government spending now.

This is aggregate public spending, so it should already be factoring in local government spending.

>>If we pretend there's been steady investment, and imagine stable demand, the same thing can cost more than it did before.

Per capita GDP has increased in inflation-adjusted terms, so when social welfare spending as a percentage of GDP increases, that means a real (inflation-adjusted) increase in per capita social welfare spending.

The only possible way this leads to less support for citizens in need is growing mismanagement of the funds by the social welfare programmes.

You asked how this amounted to Tory penny pinching in another stub but you're answering it. Since Tories came to power in 2010, a 1.3% fall in all social spending in an economy that has grown slower than inflation means an actual terms cut.

It's important to note that social welfare also covers housing, unemployment and other things not care in the same sense as being discussed. Housing costs have exploded in price so even more of that stagnant budget has been diverted away from care.

Once you allow for inflation, there is a growing underspend in care. A starvation. Yes, generations of growth, but not finding it appropriately now (and for a decade) means it's being starved.

https://www.health.org.uk/publications/long-reads/health-and...

I'm leaving it with the Health Foundation, there. I'd suggest you read that if you really want an appreciation of how budgets and inflation work together but if you just want to tell me "they have more money, so it's being wasted more" you don't understand how money works; I can't help you.

And if you're reading around, be wary of COVID era numbers as they include boosts for testing and extraordinary measures. Nothing that increases provisionable service.

If spending was the issue, the doubling of social welfare spending's share of GDP would have provided such a massive amount of resources to these programs that a 1.3 percent drop in relative spending wouldn't lead to the dire outcomes this article references.

And if you call the Tories reducing spending by 1.3 percent of GDP, what do you call a doubling of spending as a share of GDP? The Big Picture here is massive spending growth over the long run, that totally eclipses this minute drop.

>>Once you allow for inflation, there is a growing underspend in care

Wrong. The UK has seen significant per capita GDP growth, after accounting for inflation.

So rising social spending as a percentage of GDP means rapidly rising inflation-adjusted spending per capita.

If everyone is taking care of the elderly there is no one left to generate the wealth that props up society.

Community care is far cheaper for society than having families take on extra dependants, especially at the most taxable end of their lives. Its interactions with the economy are very much like childcare.

But neither are happening. Old people are abandoned to healthcare providers. This, in turn impacts on the life expectancy of much younger people requiring emergency care who won't get it because the hospital and ambulances are full. It's not sustainable for patients or providers.

There are two ways out. Choose to do this properly, or choose a much uglier withdrawal of care for the old and infirm.

Before you choose, remember that these are people who worked for 45 years being told that their National Insurance payments were paying it forward for this kind of care. If you're going to change the rules —and especially if you're going to start incinerating grandmas when they get "too costly"— you have to expect the next generation probably isn't going to stick around. Many of that exodus will be doctors.