MY local Momentum group recently discussed social care. The speaker, talking about her mother who had dementia, asked how many people in the room had personal experience of relatives with dementia. Over half the meeting raised their hands. As we get older, more and more of us will need personal care and ask society for help in providing it.

The crisis in social care is the part of the welfare state that Beveridge never tackled, because in the 1940s no-one predicted how long we would live. We enjoy longer lives than any previous generation did, thanks to the NHS, modern medicine and the welfare state, but at a cost: the associated illnesses, principally dementia. The 1945 Labour government abolished workhouses and the Poor Law, in the National Assistance Act 1948, so that was something of a revolution. The next policy shift was Thatcher’s “care in the community,” contained in the National Health Service and Community Care Act 1990.

The principle, had it been properly funded, was not such a bad idea, releasing people from institutions and treating them as individuals to be supported rather than problems to be contained. But without adequate funding, the consequences were always going to be increased reliance on family carers, overwhelmingly women, people left isolated as their conditions deteriorated and means-tested care services, delivered too often by private providers.

All of us, at some time in our lives, are likely to need the services of the NHS. These days, most of us are also likely to need some social care services. Even allowing for the dreadful impact of cuts and re-organisations in the NHS, the contrast in treatment is striking. A cancer patient receives free health care, free prescriptions, free aids, services at home and free hospital stays, and is (theoretically at least) entitled to the same level of care wherever in the UK she or he lives.

Someone with dementia must pass their local authority’s eligibility criteria (which might be different to those of the local authority next door), pay for services at home and for residential care (including by selling their home) and only receive state support after a demeaning means test.