Paying for Care

Community Care reports on a study which has been published by the Joseph Rowntree Foundation which proposes a  number of recommendations which could be implemented to make the way that adult care is funded in the UK ‘fairer’.

The report is extensive but there are some interim recommendations made which they claim could be put into place within the bounds of the present system.

They are as follows

  • Equity release, allowing older homeowners to pay for home-based care by deferring the costs until their home is sold. Cost: estimated £33 million a year
  • Higher capital limits for care home fees to help those with modest assets by raising the ceiling that dictates whether an individual in a care home receives support from a local authority (from £22,250 to £42,500). Cost: £280 million a year
  • Doubling the personal expenses allowance to give more dignity to people in care homes supported by local authorities who currently have just £21.90 per week to cover personal items such as clothes and shoes. Cost: £250 million a year
  • Free personal care for all people requiring nursing care to remove inconsistencies between whether or not nursing care is funded by the NHS or the individual. Cost:  £212 million a year

They all seem to make perfect sense to me. I have to say my understanding was that the local authorities (or at least the one where I work) are already able to attach charges to a property so that the money owing becomes payable when it is sold rather than immediately but I am fully able to accept that I have never investigated the details enough to be sure of the details.

Higher capital limits would make a difference but it is still splitting those with property from those without – in fact, it makes it more likely that the charges will be further restricted to those with property. I have to say, and I make no friends here, I don’t actually have an issue with charges being raised to those who are able to pay. There is an expectation of free care which is untenable and if someone has to pay, I would prefer that those who can afford it do and it is not at the expense of those who can’t.

Personal expenses are currently risible. They absolutely need an increase – but the money has to come from somewhere. Unsurprisingly, it always does.

Again, free personal care to those requiring nursing care. It makes sense logically but practically the costs are potentially enormous.

If we look at the proposed costings for these four interim measures, it adds up to £775 million a year.

So while these proposals without doubt would promote fairness, what are the proposals relating to raising money to pay for them?

The report provides some models for different charging mechanisms including social insurance, bonds and different equity release models but honestly, it doesn’t seem that any of these models can be practical in a wide spread national basis as the examples that the report gives are very limited in their scope and very localised.

Waterloo Bridge

Personally, I suspect insurance may be a way to go in the future regarding payment for care. It is not going to be possible nor realistic to expect fully funded free social care without an increase in costs and it is unlikely to be much of a vote-winner – especially as we are already seeing cuts being made in local authorities’ budgets.

So as for the report, it reads to me like an idealised version of what is needed and the reality is likely to be an interpretation or a representation.

The changes suggested to make the system ‘more fair’ seem to be sensible but the cost implications are, I think, too high.

But as a starting point, it has a lot to commend it.

The expected Green Paper on the Funding of Adult Care could potentially make interesting reading – which it isn’t possible to say for all government initiated documentation!

4 thoughts on “Paying for Care

  1. Good Morning CB,

    I had a Faye Saville contact me asking me if I would be willing to fill out a survey for her research on the Baby P case. I have referred her to you and to community care. I told her I would be happy to do it but that I felt you all would be better equipped to do the survey because I know very little about the specifics of the case. She will probably be contacting you about it. I hope that was ok?

  2. It’s been the trend for the last 15 years or so here to recommend people over 55 get “long term care” insurance. I don’t know for sure, since I don’t work in nursing homes, but the social insurance here for elders, Medicare, (which kicks in after one turns 65) only pays for a certain amount of time and then expenses get shouldered by the families.

    • Here it is a bit of a hotch. Social care is a hot potato because medical care is free so the distinction between what counts as ‘health’ and what counts as ‘social’ is crucial and it is very hard to determine in situations such as advanced alzheimer’s.

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