Experts call for end to social care crisis after 25 years of dithering | UK | News (Reports)


Social care worker breaks down over clients lost to Coronavirus

Sir Andrew Dilnot was appointed by David Cameron to sort out the funding of care and support in England. He recommended a lifetime cap of £35,000 on social care costs to ensure the state stepped in to help where people face catastrophic costs. But the proposal was discarded because of the cost.

Since then, former economist Sir Andrew has watched the social care system collapse.

He said: “We haven’t spent anything like enough money on social care. There has been a significant and persistent underfunding.

“And that, combined with the way social care is structured, has led to a sector which entered the Covid crisis under enormous pressure.”

He added: “A succession of governments of all political complexions have been talking about solving this over the last 25 years.”

Before the pandemic, adult social care services faced a funding gap of almost £4billion by 2025.

Local authorities now say they need an extra £6billion to deal with the impact of coronavirus.

People needing social care, either in a nursing or care home, or help with essential tasks in their own home, have to pay for it if they have more than £23,250 in assets – including their property.

Carer helping woman walk

Adult social care services faced a funding gap of almost £4billion by 2025 (Image: Getty Images)

Prices vary by geography but in London costs of around £1,000-£1,200 a week are typical.

Figures based on Department of Health data found more than 17,000 pensioners were forced to sell their homes to pay care costs last year.

It means that 30 percent of those who pay for their care have to sell their homes. The sales are thought to have helped pump more than £4billion into the care system.

Other research by Age UK found self-funders have spent £7.3billion in the past year alone. In England, 167,000 older people and their families are estimated to fund their own care because they do not qualify for free or subsidised support.

Some 5,190 people aged 65-plus and receiving care in England in 2018-19 were self-funders with depleted funds. This is up 37 percent on the previous year.

Sir Andrew, who spoke exclusively to the Daily Express after his speech at the ILC-UK conference on ageing, said: “Risk-pooling – or insurance –spreads the risk. Everybody pays a certain amount, but no one has the risk of losing everything.”

Sir Andrew Dilnot

Sir Andrew Dilnot was appointed by David Cameron to sort out the funding of care and support (Image: Handout)

He added: “The cap which we described in 2011 is effectively the excess in a social insurance policy.

“Anyone who had high social care needs would be looked after by us all. Only by doing this can we not only take away the fear and difficulty that faces people who need social care, but also do something to make the sector viable. Right now it’s like being a shop with no prices, because although we know how much we have to spend per week, or month, on your or your parents’ social care, we don’t know how many weeks or months that will go on for.

“Until we stop that almost all consumers will want to buy the cheapest products they can to meet the statutory requirements.”

My mum-in-law had to sell home to settle bills

Patricia Phipps had to see her widowed mother-in-law’s much-loved family home sold off to pay her care bills of £5,500 a month.

At 80, her husband’s mother could no longer manage on her own and went into a nursing home in 2009.

Patricia Phipps

Patricia fears she will face the same dilemma if she goes into care (Image: Steve Reigate/Daily Express)

A decade spent there until she died in June at the age of 91 cost her virtually everything she had.

Wandsworth Council in London offered to defer payment for the fees for just three months while her family put her house on the market.

Mrs Phipps, from south-west London, said: “The bills came pouring in and we had no choice.

“It’s awful the way the Government pressures pensioners to sell their homes. This lady had grafted and scraped her whole life to pay the mortgage on that house. She had raised her son there.

“I know she would have liked to have left an inheritance. She has grandchildren and I’m sure she would have liked to have seen them benefit from her hard work.”

The 67-year-old former housing association development manager added: “The social care system is not fit for purpose. I fully expect to have to sell my home too.”

Comment by Simon Bottery

There are many long-term problems with adult social care – but the most fundamental ones are how we decide who gets social care and how should it be funded.

All four approaches here use money raised from the population – whether through tax or social insurance – to fund social care.

This is called “pooling risk” and is how the NHS works. However, lots of people with real need miss out because they have too much savings or property to have their care paid for. So the most fundamental reform required is to provide more public funding to support more people who need social care.

We could certainly make the current system more generous by raising the current savings limit. But people who didn’t qualify could face huge bills. The “cap” model tries to fix this, but could result in a complex system.

An apparently simpler system is the “free personal care” system in Scotland. Yet there is critical detail about what counts as personal care and it is likely to be the most expensive of the options.

One possible advantage of social insurance is that the money comes from a fund. However, it would be complex and take years to build up, so it would need to be supplemented in the short term.

The solution overall?

First, we need to accept that people who can afford it will have to help fund the costs of care.

Then we should design a “mix and match” approach, which takes elements of some of the different systems and welds into one.

It would inevitably involve compromise and trade-offs. But it is achievable.

Simon Bottery is a senior fellow at The King’s Fund


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