Does the Chancellor realise that care can’t wait?

On Wednesday 5 December, the Chancellor of the Exchequer, George Osborne, will be giving his Autumn Statement to Parliament. After the Budget, it is one of the most important events in the Chancellor’s calendar. He will be explaining the current economic situation facing the country and will detail some of the Government’s plans for the future.

This is the perfect opportunity for the Chancellor to show that the Government is serious about tackling the crisis in social care. Back in July, we saw the White Paper, Caring for our future, which set out a range of proposals to radically reform the social care system. These included a minimum eligibility threshold, more rights for carers and reinforced by media reports , a commitment to the principle of capping the cost of care, to name just a few.

AgeUk at the Treasury with George Osborne MasksShould these proposals be implemented, they have the potential to make a huge difference to older people who rely on social care to live with dignity. However, the Government have yet to explain how they plan to fund these proposals, risking the whole process being kicked into the long grass. Continue reading “Does the Chancellor realise that care can’t wait?”

Worth waiting for? The Draft Care and Support Bill

As the Law Commission first began work on its review of adult social care in 2008 it seems reasonable to describe the new draft Care and Support Bill, based on the Law Commission’s recommendations, as ‘long awaited’.  So has it been worth waiting for?

Throughout its work the Commission was adamant that it did not intend to reduce the rights of older and disabled people who need care and support.  That the Law Commission has largely achieved its aim does in itself deserve praise, not to mention a sigh of relief that essential rights have not been swept away.

The Law Commission’s recommendations were never intended to be revolutionary. The aim of the exercise was primarily to consolidate existing legislation. This meant both bringing together successive acts of Parliament and proposing a new structure for regulations and guidance issued under the new act. Guidance will also be pulled together into a single code of practice, a huge improvement on the current mass of guidance, good practice guidelines, and guidelines produced by third parties.

There are, however, some dramatic and welcome new proposals in the draft bill;

  • A general duty to promote the wellbeing of service users will become the underlying principle used as a basis for interpreting the rest of the legislation;
  • People who do not meet eligibility criteria will still have rights to advice and information;
  • Carers will, for the first time, have the same rights to services following assessment as care service users;
  • There will be a new national framework for eligibility for care and support (the White Paper also promises a new minimum threshold for eligibility by 2015 although this is not in the draft Bill)
  • There will be improved transition arrangements for service users who move from one local authority to another;
  • Legislation to safeguard adults at risk of abuse.

Continue reading “Worth waiting for? The Draft Care and Support Bill”

Guest blog – Getting it right when it’s complex: Person-centred care for people with complex needs

This guest blog was contributed by Kate Gridley, Research Fellow, Social Policy Research Unit/School for Social Care Research, University of York.

It was with tentative optimism that I read the short paragraph in the Government’s recently published social care white paper that proposed that everyone with a care plan should be allocated a named professional to take responsibility for care coordination. The importance of on-going support to help people access and coordinate services, for example from a dedicated case manager, was a key finding of the research we recently carried out at the Social Policy Research Unit (SPRU, University of York) into good practice in social care for people with severe and complex needs.

For this study we consulted people with complex needs (including older people with dementia), family carers and members of specialist voluntary and user organisations, about what they consider to be good practice when someone’s needs are severe and complex. In addition to a person centred approach to everyday care and support (for example from a known and trusted helper ), participants valued person-centred support to arrange and coordinate care, over time, from a case manager or other individual who knew them well and had expert knowledge of their needs and the services available to them.

photo credit: David Blumenkrantz

When we carried out a literature review to scope the evidence on good practice for people with complex needs, we were disappointed to find little robust evidence about what works. However, there was some evidence in support of intensive case management for older people with severe dementia. In a study by Challis and colleagues (2002), older people using a community mental health service who received case management had reduced needs compared to older people using a similar service with no case management, and their carers experienced less stress. What’s more, after two years 51% of the case management group were still living in their own homes, compared to only 33% of the comparison group.

Continue reading “Guest blog – Getting it right when it’s complex: Person-centred care for people with complex needs”

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