Keep calm, but note the warning

Whilst social care reform proposals remain bedevilled by an inability to find a funding solution, the Office for Budget Responsibility (OBR) has published its annual Fiscal Sustainability Report.  As last year, this warns of the age-related risks to public finances in the longer term – which, to the OBR, is 50 years.

Its big picture forecast is of rising costs on health and pensions, offset by falls on public sector pensions, and of shrinking revenues from parts of the existing tax base especially oil and gas and (because of globalisation) corporation taxes and VAT. It expressly does not call for more fiscal tightening in the medium term – the period in the Treasury’s sights to 2017 – but it concludes that “governments would be likely to need some replacement sources of revenue just to keep the tax burden constant, let alone to meet the costs of an ageing population”.

Comparing 2016/17 with 2061/62, the OBR sees:

  • health spending rising smoothly as the population ages from 6.8% of Gross Domestic Product to 9.1%;
  • state pension costs increasing from 5.6% to 8.3%;
  • social care costs growing from 1.1% to 2%;
  • gross public service pension payments falling from 2.2% to 1.3% – or in net terms (including contributions) from 1.7% to 0.9%.

The shortfall in tax revenues are even less easy to project, but could amount to 2% of GDP or more.

These percentages translate into big money – in today’s terms, 1% of GDP is about £15bn. But it is striking how modestly social care features in these estimates. And of course, all the calculations are based on what we are doing today and cannot reflect any significant change in public habits and behaviour, or indeed scientific breakthroughs, such as finding a cure for dementia.

Meanwhile, what do we know about the public’s attitude to paying higher taxes for better public services? The picture is often contradictory. Polling by MORI shows that in 2010, 58% of the public supported cutting public services to pay off the national debt, but by June this year, that had fallen to 46%. The British Social Attitudes Survey, covering the years 1998 to 2009, showed a falling appetite for spending more on welfare benefits for the poor if it led to higher taxes: different age cohorts hold different views (with older generations being more supportive), but nearly half the baby-boomers, for example, supported this proposition at the beginning of the period, but only a third by the end. There has been a slow but steady shift from supporting a society which emphasises social and collective provision of welfare towards encouraging individuals to look after themselves – the balance is now 51:49.

The row about social care reform, of course, is that people probably would do more to look after themselves if the reforms gave them a credible platform to do so. That was the whole point of Andrew Dilnot’s proposed caps, which we now learn the Government agrees with in principle. If we look at the OBR’s rather gloomy forecasts we cannot have these proposals too soon, both for social care per se and for getting more efficiencies into the health service. Kicking these decisions into the long grass is not going to make the OBR any less gloomy next year.

Read Age UK’s briefing about the Governments proposals for social care reform

Find out more about our Care in Crisis campaign

Guest Blog: why I welcome the Government’s actions to overhaul social care system

This blog was contributed by Dr Dan Poulter, Conservative MP for Central Suffolk and North Ipswich and a member of the Health Select Committee

Yesterday’s announcement by the Secretary of State for Health on the Government’s plans to radically reform the way we support and care for our older people is both welcome and long overdue.

For too long, our frail older people have been pushed from pillar to post when attempting to navigate our unwieldy social care system. The Caring for our future White Paper shows that this Government is getting to grips with reforming the system of social care so that frail elderly people are treated with the respect and dignity they deserve.

Redesigning health and social care services to provide dignity in care for older people is the biggest human and financial challenge facing health and social services. Continue reading “Guest Blog: why I welcome the Government’s actions to overhaul social care system”

One year on from Dilnot

One year after the Dilnot Commission’s report into the funding of long term care,  an ICM poll reveals that 89% of English adults believe that older and disabled people shouldn’t have to bear all the costs for support with everyday tasks such as eating, washing and dressing, even if they have a small amount of savings.

This represents a wholesale rejection of the current system, in which if you have more than £23,500 in savings and need support with basic tasks like eating, washing, dressing or leaving the house you have to pay the full costs of that care. 

At present, every adult in England has a one in two chance of needing care
costing £20,000 or more in life and a one in ten chance of needing care costing £100,000 or more. Once you move into a residential home the value of your house is included in calculating your savings.

Under the Dilnot proposals- commissioned by the Coalition Government – a suggested £35,000 limit would be placed on the amount of money that an individual would have to pay towards their care.

This survey gives extra weight to the Care and Support Alliance’s call to the Government for urgent reform of the social care system which leaves too many of our most vulnerable members of society without the support they need or terrified of spiralling costs.

A year after the landmark Dilnot report into social care funding, we are still waiting for the Government to publish its long awaited White Paper on Social Care and, equally crucially, plans for how a future system would be funded. The longer they hold off on reform plans, the longer older and disabled people and their families continue to go without the support they need to live decent and dignified lives.

Age UK is calling the Government to urgently deliver robust and effective change to care and support in England. The new system must be based on the principle of fairness. All those who need care and support must receive it; the quality of care must be of a standard that delivers the dignity people deserve; and the fear of incurring catastrophic costs as a result of needing long term care must be ended so that those who have worked hard all their lives do not lose everything.

The problem of care in later life will not go away and it is getting worse. Putting off the solution does not help families in England. Change must happen now.

Find out more about Age UK’s Care in Crisis campaign

Care Can’t Wait

Last week, Age UK presented Number 10 Downing Street with a petition signed by over 130,000 people calling on the Government to end the crisis in social care.  The size of the petition means it is likely that Parliament will be required to debate this important issue, bringing the needs of older people who are being let down by the care system to the forefront of all MP’s minds.

David Gower, who shared his personal experiences of social care in support of Age UK’s Care in Crisis campaign, attended Number 10 Downing Street to present the petition. He said ‘We need reform because we need to be able to help those who are unable to help themselves and there are many members of the United Kingdom’s citizens in this unfortunate situation. We do not and cannot afford to have a crisis where people at the moment are brought home from hospital, dumped in their flats and told to get on with it. It’s time to change right now.’

The next month is set to be critically important for all our futures, whatever our age.  Having been beset by delay upon delay, the Government has indicated that it will finally publish the Social Care White Paper either this Summer.  A Draft Bill will be published hard on its heels before the end of this parliamentary session in July.

Legislation and reform is urgently needed.  Social care provision is now at breaking point as chronic under-funding, a conflicting and confusing legal framework, and an ageing population have created a crisis in social care, betraying some of the most vulnerable people in society today.

But this historic opportunity to provide root and branch reform and funding for social care comes at a time of austerity measures, and serious economic uncertainty.

Ministers have indicated that the White Paper and Draft Bill will mainly deal with reforming and simplifying social care legislation, which will go some way to ending the iniquitous postcode lottery of care provision experienced by thousands of older people across England. 

But it is the issue of how to fund social care that remains the most critical, and most divisive.  Cross party talks have been underway since January 2012. Ministers and their civil servants will have engaged in long, hard discussions with the Treasury on the future direction of funding. 

It’s not clear at this moment in time, whether consensus has been reached, either within Government departments or across the political parties.  The Government has said that it will publish a funding progress report at the same time as the White Paper.  Age UK is hoping that the progress report will contain a positive response to the Dilnot Comisssion’s recommendations for a maximum £50,000 cap on the cost of an individual’s care, which will protect older people from the sometimes catastrophic costs.

Funding and reform of social care is one of the key challenges for this Parliament, and indeed this generation of politicians. 

Even set against the austerity measures, there are positive choices the Government can make.  Funding and reform of the current social care system will help older people stay healthy and independent for longer and reduce the pressures on the National Health Service. 

At this critical moment, Age UK is therefore urging the Government to use the White Paper, the Funding Progress Report and Draft Social Care Bill, as the foundation stones of a sustainable, and fair social care system.  After 25 years of political prevarication, resulting in trauma and loss for hundreds of thousands of people, it is now time to resolve the crisis in care, and guarantee dignity for each and every one of us.

Watch a video of David Gower explaining why he is supporting Age UK’s Care in Crisis campaign

Find out more about our campaign

The Party Conferences and Public Service Reform

The headline stories from the Party Conferences were about the economy, and the orchestration by the organisers and managers to present their parties in themost favourable light.   Party members were a bit thin on the ground, but lobbyists were there in abundance.   Yet around the fringe meetings, the theme of public service reform was vigorously discussed.

Public service reform is one area to which all the parties subscribe with varying degrees of warmth.   The common ground is that we cannot provide services in the top-down way as in the past:  they must be more user-responsive and ‘personalised’, and we have to re-configure them to get more outcomes for less money.  

How we do this is more difficult.   Localism, enshrined in the Coalition Agreement, passes more responsibility to local government and local representatives, with a diminished role for the centre to set national targets and eligibility criteria, but local councillors attending the conferences were in two minds about having this task thrust upon them.   They will need to rethink their role:  are they the voice of the Council delivering the services, or are they the voice of the neighbourhood, demanding that the Council needs to change the way it provides services (ie place-shapers, seeking new powers for community groups and other service-providers in their patch)?  

Nowhere was this more hotly debated than in the area of social care provision, a big ticket spending item for local government, and one where there is a policy vacuum as the Government tries to draw a new map which triangulates national entitlements, local flexibility in service responses, and encouraging new service providers to enter the market.

That last was also discussed on the fringe.   How do we enable more mutuals and social enterprises, and support more local volunteering, to add to our public service offering?   At all the conferences there was willingness to engage with this issue, but a raft of difficulties and barriers was identified.  

We are spreading the word about models of good practice very poorly.   There are few immediate places where would-be providers can access good information about extant working models.   There is little resource for the consumer who is encouraged to take control of their personalised budget to find ideas and inspiration.   Whilst at all the Party Conferences there was willingness to address public services reform, there was a shared frustration with how to do so.

Find out more about our party conference activity

Voicing our expectations of the Government

This blog was contributed by Tom Wright CBE, Chief Executive of Age UK

I spoke at the Conservative party conference in Manchester this week about our ageing society, alongside Oliver Letwin MP, Daniel Poulter MP and our ambassador Diana Moran. This was part of Age UK’s work across the three main political party conferences.

It was an opportunity to voice our expectations of the Government and emphasise the contribution that older people make to our society.

I’m sure you will all agree that it is great news that the population is ageing well and living longer – it is one of the best achievements of this century. We must not see ageing a burden but as a contribution to our society.

We need to make it easier for older people to contribute. The removal of the Default Retirement Age means older people can no longer be prevented from working simply on the grounds of age. It is also important that we recognise the importance of volunteering and the contribution that older people make in their communities. At Age UK we have 70,000 volunteers of which three quarters are older people.

In my response I set out three issues that the Government and the party could deliver and which could transform the lives of older people by 2015:

  • Abolish pensioner poverty by overhauling the means tested state pensions system and create a universal pension of £140 paid to all.
  • Implement reform of social care, to end the unfairness of the current social care system.
  • Older people being valued and contributing to society so that their experience can be used to shape their communities.

Other contributors to this debate had interesting things to say. Daniel Poulter pledged that the Government would address the underfunding of care; this is a key issue for Age UK. We are calling for the Government to take action to reform our care system by acting on the recommendations of the Dilnot’s Commission’s report on the Funding of Care and Support.

From a personal point of view, Diana Moran spoke about the needs of an ageing population. She said that it was important that different services worked together and that individuals were given the information they need to stay independent. Diana felt that this was particularly important for people who are less fortunate and less well.

At Age UK we very much agree; we must work together if we are going to make our country a better place to grow old. We are all living longer; let’s make the most of it together

Find out more about our party conference activity






A stride in the right direction

Here’s hoping the 4th July 2011 will go down in history.  The day that Andrew Dilnot made successful recommendations for long term care reform, that the Government accepted, took forward in legislation and were implemented with pace.

We have a long way to go before we can claim success, but Dilnot’s proposals for reform are a good start towards this goal.

Andrew Dilnot was given the unenviable task of proposing recommendations which would create a better care system, one which was more sustainable, fair, easier to understand and affordable.  He has worked meticulously, gathering evidence, statistics, views from the general public and from stakeholders such as Age UK.  In subsequent blogs I will look at each of the tests in more detail, but here are some initial reactions to his proposals:

1. We welcome that Dilnot has called for more national funding – between £1.3bn and £2.2bn.  Without investment in social care any reform will not be sustainable and is liable to run into future difficulties.  We have repeated throughout this process that the Government cannot afford not to reform care, and that by investing in better essential services the Government will save more in health, housing and welfare interventions.  We know there will be a big debate about where this money comes from, but these issues can be answered.

2. We also welcome the increased certainty this package of proposals sets out.  Whilst £35k is not insubstantial, the reality is that many people pay more than this currently for their care, and those that don’t are fearful they might have to.  What the cap does is take the guessing game out of care and encourages people to plan ahead and to think about their future.  It’s one of the big disincentives in the current system and the cap will remove this. Continue reading “A stride in the right direction”