16 October 2013
It would appear that the long-awaited Care Bill, currently going through the report stage in the House of Lords, is not going to bring the much-needed peace of mind promised to many thousands of elderly people and their families.
The reforms to social care contained in the Bill, are in large part based on the government-commissioned Dilnot report on funding social care.
Dilnot originally recommended that a cap of between £23,000 and £50,000 (with a suggested figure of £35,000) should be placed on the costs of long-term care. The government had already deemed that a cap of £35,000 would be too costly and set the cap at £72,000.
Whilst setting the bar high, in my opinion, this figure at least allows people to plan and budget accordingly.
Dilnot also recommended a universal deferred payment scheme which would see councils paying for the costs of care and recouping them once the person’s house was sold, typically after the person in care had died. This significant scheme was to reduce the number of older people forced to sell their homes to pay for care.
But, it would appear that the government is going to change the goal posts for this scheme so that it would not be available to anyone with assets, on top of their home, of more than £23,250.
What this would mean is that anyone with savings, investments, shares or any assets over £23,250 would have to spend them in order qualify for the scheme. Very few people will now qualify for the scheme. So we are right back where we started with people who have worked hard, spent and budgeted wisely and paid income tax and national insurance being faced with the prospect of selling their homes in distressed circumstances.
As I have said before though, the Dilnot report and now the Care Bill miss a fundamental point – and that is the issue of how we provide care, who to and at what stage. The issue of who pays for care and how it is funded is certainly important but, for me, the bigger strategic issue is ‘how do we cope?’ and ‘how should our care services look in the future’.
It is my belief that if we spent more on ‘care’ rather than ‘cure’ then people would need less support overall. We could save millions across the health and care systems if we took an integrated view of health and social care.
The systems need to evolve to provide person-centred care that is both age and stage appropriate and which support healthy ageing. With ever increasing life expectancy ‘old age’ now covers a huge spectrum and we need to innovate and take a holistic approach to meet people’s needs.
If we could get social care right, we would keep more people out of hospitals and enable them to remain in their own homes, living a relatively independent life, rather than go in to a care home earlier than is necessary.
So, let’s make sure we focus on how we care rather than who pays for it – get the ‘how’ right and it will make the ‘who pays for it’ a lot easier.