Rethinking Care Funding

An interesting headline in the Independent caught my attention  this morning.

‘Affordable old age – U-turn on money for elderly care’

So the  story develops, in the Independent, along with other papers that the government (via a ‘senior sources within both coalition parties) that the Dilnot proposals to fund adult (note – adult, not ‘elderly’) social care in England.

Dilnot’s ‘headline’ proposal was that there should be a cap on the limit of personal liability for the cost of care fees and this development suggests that that limit may well be set at £35000.

The article explains

A Whitehall source said: “They’ve come to the conclusion they’d be mad not to do it. It’s all about the legacy. It means both the Conservatives and Liberal Democrats can turn round in 2015 and say: ‘We sorted out social care. Because of what we did no one will have to lose their homes to pay for nursing home care any more.’ That’s a pretty big achievement – and would appeal to both sets of voters.”

Now this narrative of ‘losing homes to pay for nursing care’ is a basically incredibly simplistic for a start as it doesn’t really take into account the conditions that currently exist about when that may or may not happen. It does, however, grasp on the ‘tabloid narrative’ of the terror of the home owning generation that they might actually have to use some of their assets to pay for the high cost of care.

You see, I have a problem with Dilnot and care caps while seeing it is politically pleasant. Care has a significant cost.  Caps are good politically but there will need to be significant investment of money and the ‘cap’ is solely in terms of ‘care costs’ and wouldn’t cover the ‘hotel costs’ of residential care.

Protecting inheritances though, fits well into the coalition narrative and without doubt, there’s a need for the basis of social care funding to be rationalised. I hope the coalition move beyond the ‘selling homes to pay for care’ narrative that’s overplayed and under-understood.

See, the other interesting little tidbit of information in this report from the Independent is that

The Treasury is expected to argue that the plan should be paid for out of the general NHS budget. But that could create problems for Mr Cameron, as Labour could argue that funding care was robbing hospitals and frontline services of cash.

This will add significant pressure on the NHS – however it does potentially free up the local authorities from some funding responsibilities that they already have. This remains a worry. What I need to see to be satisfied with this proposal is detail about where and how the money is going to be made up when the cap is in place.

A move on Dilnot though (which is about more than caps – believe it or not and you wouldn’t necessarily if you just read the headlines) would be a definite positive so I’m not knocking it.

I just wonder about headlines that talk about ‘affordable old age’ – affordable to whom? Sometimes affordability comes at a cost. I want us to achieve quality care for all those who need social care input and it will cost. It’s a matter to consider where the burden of that cost will lie. As long as the money is extracted from a stretched NHS budget without further injections of cash, I can’t be as overjoyed as I would like to be about this u-turn.

I’ll retain my sliver of cynicism until we have more details.

Care Lobby 2012

Londra - The House of Parliament e il Big Ben
Today there will be a lobby and representation made to Parliament by the Care and Support Alliance – which is an umbrella organisation of a number of charities and representative groups for people with disabilities, illnesses and their carers.

The Care and Support Alliance is campaigning to change the current system of care which exists, claiming there is a ‘care crisis’ which needs fixing and is pushing the government to act on Dilnot’s proposals to change the system of funding for social care.

There is much that needs to be changed – not least the funding of care which at the moment is very dependent on location. It is a postcode lottery of funding in every sense of the word with different local authorities having very different systems which creates a very extrinsic ‘unfairness’.

But there is  more that needs to be changed than just creating a more equitable national system of payments for care. There is much about the way care is delivered, commissioned and organised that needs changing too.

There needs to be an improvement not just of the quality of care that is delivered but the quality of support that is offered to families of people who have care needs. While the government can have as many meetings about improving dignity in care as they like, these reports will all sound the same unless they do more to change the fundamental way that services are financed and delivered. Currently pushing costs between health and social care is detrimental to those who need support from both and until there is both better integration of budgets and greater attention to the fundamental needs of

I am very much in support of the Lobby today. For those who are not able to take part in person (like me, as I’ll be at work), there are ways to take part and show support online both on Facebook and Twitter.

Everyone needs to push on this point. We have to actively engage with the government to show them how much this matters and how much it matters that social care is important as a political issue. Health and Social Care are intrinsically connected and money pushed between one and the other without proper systems will cost more to both but not much in money, in quality and length of life, in stress and distress to those who need care and those who provide it.

The government has to act. Please join the Lobby or the #Twobby to make our voices heard together.

photo: Gengish/Flickr