On Monday, just before the appalling revelations about the News of the World, hacking and Milly Dowler broke and understandably dominated headlines, the Dilnot report was published. It is the final report of the ‘Commission on Funding of Care and Support’ that has spent a year looking at how we can pay for the care of vulnerable adults over the coming years. It is a massively important and well crafted report that sets out a realistic financial model of how we can pay for the costs of an ageing society in years to come. I say that it is ‘really important’ because the status quo simply cannot continue – the system as it is is broken.
Previous Governments need to take a fair bit of responsibility here. After all they have had years to fix the system but didn’t. There have been numerous reports and commissions into social care over the years. They have reported with the conclusions being quietly buried shortly after. You can understand why. It is a brave politician indeed that stands up and says to the public ‘you know that you think that the NHS will look after you when you are unable to look after yourself, well actually it won’t and in fact it never has.’ But as research undertaken by Dilnot makes clear, the truth is that people do on the whole assume that. And it really isn’t something that you spend a lot of time worrying about when the issue doesn’t affect you.
The cold hard reality is that the costs of paying for social care are, on the whole, borne by those that need the help. So if you need hot meals delivering, help at home, a few days a week at a local day centre or to move into residential care and you have more than £23,250 in savings, then you have to pay. Once most of your savings have been spent, you will only get council funded services if your needs meet their criteria.
With local councils’ budgets being tight, you have to be pretty infirm to be able to get any help provided at all. If you think that you need help, then your local authority will first carry out an assessment to determine what your needs are. This assessment will categorise your needs as being low, moderate, substantial or critical. Generally councils will only help if your needs are assessed as being ‘substantial’ or ‘critical’. You will then be assessed financially and it will determine how much, if any, of the help you require will be paid for. And just to bring it to life, 'moderate needs', for which you are very unlikely to get any help anyway, means that you may not be able to get to the shops, use your bath or get out to meet your family or friends independently.
Suddenly finding that you or a loved one needs help either at home or residential care can be frightening, stressful, emotional and financially catastrophic. Help at home can cost between £10 and £20 per hour. The average cost of a room in a nursing home is £36,000 per year. The bills really do start to rack up quickly.
So back to Dilnot. These are not proposals for the state to pay for everything. The commission accepts that individuals should contribute something from their own assets towards the cost of their care and accommodation. Instead, there is a proposal for a partnership between the state and individuals that removes the uncertainty. Under the proposals, we will each be responsible for meeting some of the costs of our care but the extent of our exposure will be capped at £35,000. The capital limit will be raised from £23,250 to £100,000. After that the state will kick in and pay the rest although care home residents will still have to pay ‘hotel’ costs such as food and accommodation bills.
The proposal means an extra £2 billion or so in spending by the state a year, about 0.25% of public spending. And for that we get peace of mind that in our old age we won’t face the fear and uncertainty of not knowing how much or who will pay if we need it. Most people will still pay something towards their care. But for that £2 billion we can ensure that those with modest means will not be unduly penalized following a life of hard work and saving. And we can ensure that the poorest are protected.
It might not be at the sexy end of politics. But it matters. Right now the government is deciding on what to do with the recommendations. To be fair to them; it is a tough call. Like any balanced proposals, there are elements that will both appeal and repel the various strands of political opinion. And that is why we should all be helping to persuade them that this is not about party politics or point scoring. It is bigger than that.
Ed Miliband has promised to enter into all party talks and that is to be hugely welcomed. But we should all be writing and emailing our MPs to say that the government should, after considering and consulting, support and implement the commission’s findings as soon as possible. When there was a proposal to privatise a small proportion of the national forests there was uproar. Hundreds of thousands lobbied their MP. It sent a signal. Well this isn’t about trees; it’s about people. And that same uproar sadly appears lacking.
At the moment the government is promising a white paper by the spring. If the timetable slips, then it will be a sure sign of prolonged delay. Right now people are suffering, frightened and uncertain about their future because of a broken system. This is an opportunity to fix it.
Posted by Peter Watt, Chief Executive of Counsel and Care
This blog first appeared on Labour Uncut on 07.07.11