I’ve always liked the opening sequence of Still Game. Jack and Victor segue from childhood through adolescence and middle age, ending up as two elderly widowers. Each stage is met with an accepting smile and shrug. Jack and Victor are still game because they enjoy good health and live independently in their own homes. Their families may have emigrated, but they’re not isolated. They have a mutually supportive network of similarly placed friends and neighbours.

Off hand, I recall only a single episode featuring a carer for Craiglang’s elderly. Even then, it was only for a bit of love interest. Jack, Victor, and the other reprobates are not typical. In real life, more of them would face the reality of requiring care in old age, especially if in poor health. A care crisis, demanding answers at individual and systemic levels, is already with us.

In 2019, Boris Johnson stood outside Number 10 promising to “fix the crisis in social care once and for all”. As with the weekly £350million for the NHS and 40 new hospitals, Mr Johnson was speaking from his rear end. Perhaps he had forgotten his predecessor’s proposals for the so-called “dementia tax” that cost the Tories their parliamentary majority in 2017. The additional funding proposed by Mr Johnson in 2021 fell far short of what is needed to “fix the crisis”. Mr Johnson was rarely the master of his brief, so he may not have fully appreciated the imminence and enormity of the crisis.

The number of over-65s in the UK is projected to rocket from around 12 million to over 17 million by 2040; a mere 17 years away. It’s estimated around 1.6 million will be dementia sufferers. Research reveals around 70% of over-55s have given little thought to what their care needs in old age might be. Only 5% have planned how to meet the cost of care.

There’s no simple answer to what is a complex and pressing issue for governments around the world. Germany and Japan have introduced compulsory insurance to meet future care costs. China favours greater family responsibility, providing workers with paid leave to care for aged relatives. Whatever steps are taken in the UK, it’s certain reforming residential care will be part of the solution. Unfortunately, it’s currently part of the problem.

Covid thrust care homes into the frontline. A Warwick University Business School report on the Financial Impacts of Covid on Care Homes was subtitled “Bailed Out and Burned Out”. The title reflected the temporary funding provided for the sector, amounting to £2.1 billion in the first year of the pandemic alone. The “Bail Out” helped most care homes meet additional costs arising from the pandemic.

“Burn Out” applied to frontline staff who bore the brunt of the physical and mental stress. They were the ones who had to comfort the dying or tell relatives they couldn’t visit. The Warwick report suggests far too little of the bail out found its way to the underpaid and burnt-out staff, especially those working in “for-profit” facilities.

Salaries and dividends paid to owners and shareholders suggest the sector remains highly profitable. The owner of one of the UK’s largest providers has taken £21 million in payment over the past five years. The Warwick researchers were clear, if care homes are to be part of the solution, further government financial support will be essential. They are equally clear however, more transparency is needed to ensure “taxpayers’ support does not go to paying out dividends, bonuses, and other payments involving the extraction of value from the sector”.

Staff shortages impacting on care quality must also be addressed. There are 160,000 vacancies in England alone. Little wonder, when the average hourly rate is a miserable £9.50. Future government support must be conditional on improving staff pay, thereby boosting recruitment and retention. The charity director at AgeUK believes there is no real sense the government has “a grip on the problem.” It has been ducked for the past 20 years and whatever the answer, it won’t come cheap.