This article was originally featured in the Telegraph.
It is quite a challenge to attempt radical reform of social care in a period of public spending entrenchment. Yet to do so now is also a good time. It is painfully plain that state-provided social care is in crisis. Age UK estimates that currently there are 800,000 older people who need care but do not receive it from the state, and that this will increase to one million people by 2014.
No-one involved in social care wants the status quo to continue. Inadequate funding and a chaotic legal framework have created the perfect storm in which those in the last years of their life are routinely failed by the system.
The most vulnerable members of our society often receive inadequate support or no support at all. Others find that the only way to pay for the residential care they need is to sell the family home, a decision that only compounds an already difficult time.
This situation is only going to get worse as social care services are under growing pressure: first, as a result of stand-still budgets which have seen investment in social care increase by only 0.1% per year in real terms since 2004; second because of large cuts in central Government support to local Councils this year and planned for the next three years as well; and thirdly, because there is greater demand than ever – since 2004 the number of people over 85 has risen by two-thirds. Demand outstrips supply. Continue reading “The Government must be bold on social care reform”
The heat is on for social care. In recent days and weeks we have seen increasing coverage of issues showing how social care is creaking at the seams, and worse, that it often fails to support the most vulnerable people it is there for. Stories of unmet need, abuse and market failure are rebounding in media outlets usually quiet on these issues.
Age UK has recently published its Care in Crisis report which shows the extent of the underfunding and level of demand that is facing social care, and we predict that it will only become more stretched in the months and years to come.
We will see unprecedented budget cuts to social care in the next few years (despite the extra £2bn from the Government to boost the shortfall) and the number of older people over 85 will increase by 66% in the same timeframe. Demand will increase and supply will decrease, adding more pressure to an already overloaded system.
Which means now, more than ever, it’s critical that we have a successful proposal for reform, followed by concrete and decisive action by Government. Age UK is looking forward to the early July publication of Andrew Dilnot’s proposals for the future funding of care and support.
Indeed this is our major beacon of hope – similar commissions have tried and failed to kickstart reform and these opportunities are rare. It is vital that Dilnot’s recommendations are serious contenders for a future funding model so that in future we can be proud of our care system. Continue reading “Launch of Care in Crisis campaign”
Mr Lloyd, as Secretary of the All-Party Parliamentary Group on Ageing and Older People, highlighted in Parliament the growing age profile of our population and the need to reform the social care system now. He highlighted in particular the needs of older people suffering from dementia, their families and carers. In support, Penny Mordaunt MP stated that in her constituency of Portsmouth alone, there are 1,000 people with dementia who have no access to services whatsoever.
The debate provided many questions, but few answers. The consensus was clear that the care system needs to change. Stephen Lloyd challenged the Government to provide a minimum level of care and support to everyone for free. He argued that access to early intervention services for those with dementia would improve the lives of those suffering from the condition and would make economic sense by delaying progress of the disease. He raised the importance of respite care for families coping with a loved one with dementia and called for a guarantee of good-quality care.
But we heard little from the Minister responding (Paul Burstow MP, Minister for Care Services) about concrete proposals for reform – he, like everyone else, is waiting for the proposals of the Dilnot Commission. Dilnot’s Commission on Funding of Care and Support is due to report at the beginning of next month, and we expect that legislation based on the Commission’s proposals and those of the Law Commission on reform of social care law will be a high priority for the Government in the next parliamentary session. In the meantime, the Minister last night did not comment on Stephen Lloyd’s proposals about social care funding, saying only that “there is no perfect solution… but we need to strive to reach a settlement that requires trade-offs but also secures the necessary change and sustainability of a system for the future.”
What Tuesday’s debate did do, was to raise in Parliament the real, human impact of care services on the lives of older people. Several MPs spoke with passion about the numbers in their constituency who were not receiving support, while Stephen Lloyd talked about the impact of dementia on his own family. Social care funding is not just a policy problem to be solved; it has a huge impact on the dignity and quality of life of millions of older people in the UK and their families. When the Government legislates to reform social care, Age UK will be making sure that their voices are heard.
The past few months have been full of speculation about dissent and division between the Coalition partners; on AV, on pensions and most recently on health. Yesterday Age UK, as part of an alliance of health charities and think-tanks, wrote to all three main party leaders calling on them to put aside their political differences and work together to reform social care.
It’s clear that the social care system in England is at breaking point and badly in need of reform. Earlier this week, Age UK launched our ‘Care in Crisis’ report, which outlines the flaws in the current care system. The system simply isn’t meeting people’s needs; in England, of the 2 million older people with care needs, over 800,000 currently receive no support whatsoever from either public or private sector agencies. Funding has increased only incrementally (0.1% per year in real terms since 2004), while local authority budget cuts mean that spending on older people’s care is due to plummet by £300 million over the next four years. There are massive variations in the quality and quantity of care between different local authorities, and older service users receive less funding on average than younger ones. The system is failing to meet people’s basic needs and desperately needs to change.
There were opportunities to reform the social care system during Labour’s time in Government which weren’t adequately seized. The Royal Commission on Long-Term Care, established six months into Blair’s first term and reporting in 1999, made a series of recommendations on care reform, including paying for personal care through general taxation according to need, establishing a National Care Commission to set benchmarks, monitor longitudinal trends and represent the interests of consumers, a national carer support package and a more transparent grant and expenditure allocation system. The majority of the Commission’s recommendations were never implemented. Subsequent reform attempts were too little, too late. The Personal Care at Home Act was passed last April in ‘wash-up’ before the General Election, but relies on a commencement order to take effect. The Coalition Government announced in November last year that it would not be commencing the Act – a symptom of the failure to achieve broad political consensus on the need for reform.
But change is on its way. Last month saw the publication of the Law Commission’s review of adult social care law, which is proposing some significant changes to the legal entitlements and responsibilities accompanying social care provision. Under the proposals, there would be a national framework for eligibility, which would stipulate basic minimum entitlements to services. Care users would be able to use direct payments to purchase residential care. There would be clear legislation on the role of social services in leading and coordinating the safeguarding of vulnerable adults, a topic which is currently left to guidance. There would also be more support for carers; local authorities would have a duty to assess carers’ needs, and also a duty (rather than a power at present) to meet them. Continue reading “Social care at breaking point”
Age UK’s new report ‘Care in Crisis: causes and solutions’ opens six weeks of intense debate as we run-up to the publication of the Dilnot Report on the funding of care and support. The main purpose of our paper is to explain how and why older people’s care has reached financial breaking point. By re-analysing existing data from official and academic sources we have assembled a devastating critique of the care system for older people as it stands today.
High and rising levels of unmet need are the first signs that the system is failing. Already, out of 2 million older people in England with care-related needs, 800,000 receive no formal support from public or private sector agencies. As a result of spending cuts, combined with rising need, the figure is likely to pass one million between 2012 and 2014. Continue reading “Countdown to the Dilnot Report – Care in Crisis”
Last week Age UK welcomed over 300 delegates to our Agenda for Later Life conference. Our flagship policy conference has become a key date in the calendar for people who are passionate about improving later life.
As many readers will be aware, Iain Duncan Smith’s speech received significant coverage. Whilst the mediawidelyreported a possible universal pension set at £140 a week, in reality, the Secretary of State’s speech was more about setting out the direction of travel and the principles driving this – rather than announcing concrete policy proposals. IDS appears to have taken a bold step in persuading the Treasury of the needs for a much simpler system. This is welcomed and much needed. His speech also highlighted his aspirational goals for tomorrow’s pensioners. Age UK now looks forward to hearing what plans the Government have for helping lift 1.8 million of today’s pensioners who live in poverty.
Our ‘changing hearts and minds’ session offered important perspectives on challenging ageism. Camilla Parker (the solicitor who supported Miriam O’Reilly‘s successful ageism challenge against the BBC) kicked off the session with an upbeat message. I hope, as Camilla discussed, that the public response to Miriam’s case indicates that maybe the tide is turning in media attitudes to older presenters. Focus on the experiences of real people, show how a change in attitudes can benefit everyone and be pragmatic about the types of ageism which can be tackled were the lessons offered by renowned campaigner, Ben Summerskill. Advertising specialist, Kate Waters, used her experience of running public information campaigns to highlight that campaigns are only successful when they reflect experiences people can relate to and we were pleased to hear business leader Jacki Connor of Sainsbury’s explain the business sense in employing older workers: customers are happier being served by staff that mirror their own age and social mix.
A highlight of the day was the thought provoking speech by Andrew Dilnot, the Care Funding Commissioner. It was great that he used our conference as an opportunity to share his Commission’s preliminary conclusions. He made clear that the Commission believe that more state resources will be needed for care – but that this is only part of a solution where everyone pays more: individuals, families and the state. In such a complex social policyarea, he reassuringly confirmed that the proposals the Commission makes will be as clear and easy to understand as possible.
Alongside the conference, we also launched our Agenda for Later Life report. Earlier blogs have discussed the indicators the report uses to track public policy on later life and our 12 key policy challenges. This year’s conference was timely. It came a year after Age UK launched and well into the Coalition Government’s first year in office. Plans are already afoot for next year’s conference. We look forward to reviewing our indicators in 2012 – hopefully tracking lots of improvements – and seeing how the Government are stepping up to those 12 challenges.
To coincide with half-term week the Dilnot Commission on the funding of long term care has set out its own mid-way prognosis. This shift in gear from quiet contemplation to ‘thinking aloud’ is not before time, given the few short months between now and early July when it will report.
I was reassured that most of Age UK’s top concerns for the future of care have been taken squarely on board by the commission. Above all, Andrew Dilnot and his fellow commissioners have fully recognised that extra public spending is non-negotiable and that today’s safety-net system must be sustained and improved before anything else.
The commission is also placing great store on giving people the opportunity to protect themselves against the costs of care. They have firmly concluded that today’s means-tested system must be laid to one side; but they are equally certain that offering free care from tax funding is a political and financial non-starter. That leaves a very wide range of options involving individuals with middle and high means sharing the costs of care with the state (so-called ‘partnership’). Continue reading “Dilnot Commission… half-term report”