Health Secretary Andrew Lansley pledged to end the “postcode lottery” of social care in England from 2015 by imposing a national minimum eligibility threshold.

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Background

As heavyweight contests go, social care reform pits two of the most formidable forces shaping the UK in 2012 against each other in the ring of public opinion and political priority.

In the demographic corner is our ageing population: by 2035, on present trends and swelled by the ranks of the 60s baby boomers, almost a quarter of the entire population will be over 65.

That’s up from just 15% in 1985, and is a stark indicator of just how many individuals will be requiring even the most basic assistance with the challenges of old age.

But the systems put in place to deal with much smaller numbers of OAPs in decades past are not only inadequate to cope with that rising tide of physical and mental infirmity - they are already buckled.

Economist Andrew Dilnot, who led last year’s detailed review of the state of play, condemned it as “confusing, unfair and unsustainable” with society’s most vulnerable bearing the brunt.

One of the most frequently-cited illustrations of the failing of the present set-up is the numbers forced to sell their homes to pay for care - said to be up 20% in a decade to a record 24,500 last year.

A million people are expected to be ineligible for any help paying for care by 2020.

At the same time, deep cuts in town hall budgets are leading to homes and day centres being closed and an ever-narrowing band of the most vulnerable being able to call on such state-funded facilities.

On one level, it appears a political and vote-winning no-brainer: the fastest-growing section of the electorate is desperate for help and the experts have set out a clear prescription for a cure.

Such is the imperative that politicians of all hues have been falling over themselves to shout that it is one of their top priorities - even promising to lay off the party politics so fundamental an issue is it.

And so enters the other bruising contender in this bout. Throwing its shadow right across the canvas from the “in the red” corner lurks the dire state of the nation’s finances.

Some parts of the cure may be possible despite the tight squeeze on public spending.

Campaigners want national eligibility criteria to end the “postcode lottery”, transferable assessments across the country, better regulation and planning and help for people to remain longer in their own homes.

These are the sort of issues which are set to be addressed in detail on Wednesday - even if only at the stage of a draft Bill and not full legislative proposals.

But however effectively the system may be re-ordered, streamlined, speeded up and generally improved, it remains hard to see the long-term benefit unless an answer is found to Dilnot’s central question: how to pay.

His blueprint - which has been widely applauded by all sides - envisaged a scenario where no individual would pay more than around £35,000 in total for their care, regardless of how much of it they required.

Only those with assets of more than £100,000 should not get state help, he also suggested - up from £23,250 - with the new system aimed at stimulating a private insurance market to help people cover those costs.

The bottom line? The Government would need to spend an extra £1.7 billion a year to plug the gap. In the first years, that is - with the cost to the taxpayer rising substantially further as the population ages.

That’s an extra £1.7 billion a year at the same time as austerity Chancellor George Osborne is freezing public sector pay, slashing the armed forces and imposing the biggest public spending cuts for generations.

The opening rounds do not appear to have gone well for the reform camp. A formal backing of the principle of the cap has not been enough to persuade its promoters that it has the fight to land any knockout blow.

They will certainly not be throwing in the towel however and what is already a highly-vocal lobby will move into overdrive between now and the spending review in 2013/14.

After this weekend, one question will be whether Labour finds itself pulling back on its own gloves to join them from the outside or returning to the stalled efforts to find a non-partisan way forward.

Plans to give pensioners moving into residential care state loans so they do not have to sell their homes are meaningless without ideas on how to pay for care, Labour said today.

The announcement is part of a raft of proposals published today by Health Secretary Andrew Lansley about how to deal with England’s ageing population.

But shadow health secretary Andy Burnham said: “Despite the obvious political risks in doing so, we faced up to the difficult issue of how to pay for care and support in the century of the ageing society.

“This Government has failed to do so. With no answers on the money, this White Paper fails the credibility test; it is half a plan.

“The proposals set out today are in danger of appearing meaningless and may in fact raise false hopes among older people, their careers and families.”

The “universal deferred payment” scheme for care homes was first proposed by a Royal Commission more than a decade ago.

Since then, councils have been able to offer interest-free loans to people who face having to sell their property to pay for care.

But the scheme announced today will order councils to provide the loans.

Under the plan, relatives of residents would be able to sell the family home to pay for the care after their relation has died.

Mr Burnham said English councils were already struggling to provide services because of Government cuts and would be under more pressure after the package revealed in Mr Lansley’s Commons statement.

The shadow health secretary feared councils would charge commercial interest rates on the loans so they did not lose more cash.

He added: “If this is the case, taking on such large amounts of debt may be very frightening indeed for older people.”

Ministers’ plans follow a review of social care by economist Andrew Dilnot, who recommended a cap on the amount pensioners pay for their care.

The Government’s favoured limit is £35,000, but there was no concrete proposal in Mr Lansley’s announcement.

Mr Burnham said: “This is the problem with the Government’s White Paper. They are adopting a pick-and-mix approach to the Dilnot package which was conceived as a coherent and complementary whole.”

In his statement to MPs, Mr Lansley claimed the flagship proposal to provide loans for care would spare old people the misery of selling their houses while they were still alive.

The Health Secretary said: “No one will be forced to sell their home in their lifetime to pay for care.”

He also revealed £300 million would be switched from the NHS to fund social care over the next two years.

He told the Commons the care system would become more transparent so pensioners and their families could make better-informed decisions.

“To make it easier for people to get the care they want, we will ensure they have better access to independent advice,” said Mr Lansley.

“We will make it easier for people to see whether a care provider is good or not so they can make real choices through an online quality profile for each provider.

“We will work with a range of organisations to develop comparison websites so people can give feedback and compare the quality of care for themselves.”

The Government also said local authorities in England would be banned from buying home-help care by the minute, which imposes strict time limits on old people’s contact with their carers.

Mr Lansley said the decision to rule out the “crude practice” would mean patients were treated with dignity and respect.

He added: “We inherited a system that too often let people down and was unfair, a system which was complex and confusing and which responded to a crisis but too rarely prevented it.

“For many years people have called for a system fitted around the needs of care users, not the preferences of the service; one that puts people at the heart of the service and delivers high-quality care with dignity and respect.”

For analysis of what this means in Norfolk see tomorrow’s EDP.

Do you have an experience of being affected by the so-called ‘post-code lottery’ of social care? Leave your comments below of email newsdesk@archant.co.uk

1 comment

  • UK tax gap at £35 billion for 2009 -10 (HMRC).

    Report this comment

    Joyce

    Thursday, July 12, 2012

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