The greatest tribute we can pay to Andrew Dilnot and his commissioners is that their work has been eagerly awaited. Solving the problem of social care was not an easy ask, but the way that the commission has gone about its work means that we have been able to anticipate eagerly a glimpse of a future sustainable health and social care system.
As leaders and administrators of the system, we have joined with many other voices in showing that the current system is broken. Its more, much more, than just the ever-present financial gap. Jon Glasby has described social care as the missing pillar of the post war settlement, it's never really been seen for what it is - central to helping people live their lives in ways they choose. The missing pillar shows in peoples' lived experience of social care. It's a confusing system to access, particularly if you meet it for the first time from the point of crisis - like the frailty of being in a hospital bed and needing something to support your return home
Without great social care, there is no support around people, their families and communities to prevent their health needs worsening, or to form the basis of their recovery post hospital admission. Tensions between the health and care system have dominated the last 15 years, with talk of Berlin Walls and attempts at structural integration not all of which have been as successful as the few that have made structure work. The demographics and the changing nature of long term conditions mean that health and social care need each other more than ever. This focus on older people rightly sits behind the growing concerns about the system.
Recent media images have all been about failures in the system - whether it's the lack of drinking water in a hospital ward, or the haunting pictures of care inside Castlebeck - they are failures in the basic dignity we afford people. These failures need a response.
We also need images that invite us to repair our system. We need to build not only the analysis of a broken system but also some compelling pictures of why social care is worth the repair through society reflecting on the way we want care to work and the way in which we are prepared to pay for it.
With great social care, people with disability now live in their own homes, with carers of their choice supporting them in the way that they chose. Choice and control exercised alongside social workers who inform and empower have changed lives and outcomes. Its a young man - Michael - who showed me this week his photo album of his work in a micro enterprise: meaningful activity that gives him worth and value.
Great social care has transformed the support that is given to people who care for others, with access to information or respite care when needed. Imaginative use of individual budgets has allowed Bharat to talk with Raj about the question of being cared for - and to plan breaks in care to meet the needs and ambitions of both.
Great social care has allowed people with mental illness to transform the way that they are supported. Citizens now run their own support services, and design support that works for them. As a result Sandra became a volunteer and later joined the board of a local charity, finding her way into belonging and participating in her community rather than being part of a maze of specialist services.
Great social care is shown in services that create the skills and confidence for older people to return home, properly enabled to live their lives. It was the tears of joy falling down Charles' face as he walks a distance equivalent to his living room, knowing that soon he would be home.
All of these are transformative changes made by social care in recent years: building lives around home and community. We have shown we are a system that can change, and change not just the system but in the meaning that we give to people's lives.
So yes, we may be working in a broken system and we may face many challenges which won't disappear with the publication of a report. But social care is a system worth the repair - it has the ability to change lives. I don't just want assurance that what waits for my old age is a guarantee of basic standards. I want to know that I will be supported and enabled to add quality to the gift of long life expectancy.
Compelling pictures based on real delivery will also be part of what help me decide as a citizen about how and what I am prepared to pay or save for that old age. It will help me shape my views of the role I am prepared to play and my expectations of family, community and state support. I expect the Commission will help us decide together how we build a sustainable social care system. ADASS will support the debate that is needed to help us all decide how we build upon the challenges and opportunities the report will present. We need that debate.
This time we have to address this issue. Not just because the serious work of Andrew Dilnot and his team, but because its about finally putting the social care pillar into the fabric of our society and securing the place it must play in supporting people to live the life they choose.