Today the Institute for Public Policy Research publishes a study about adult social care on the cusp of the publication of a new Green Paper next month.
As they claim, the study
seeks to generate public debate about the future of social care; and consider how the social contract between the state, organisations, communities, families and individuals may need to fundamentally change to ensure that the future of social care is based on principles of fairness and sustainability.
Quite a substantial task!
It does make interesting reading though – especially as the gap between expectations which have possibly been raised to unrealistic heights by a free health care system and realities which are that the costs of social care in a society which is ageing can only increase – possibly exponentially.
What is clear is that no-one wants to pay for services. No-one wants to have to sell a property in order to fund care services. No-one wants family members to be obliged to pay for care services. No-one wants higher taxation levels to pay for care services. But everyone wants high quality care services that are not means-tested and are, like health care, free at the point of delivery.
So looking back to the study, the main points raised were that
- Low awareness and uncertainty: confusion about the nature of social care services
There was shown to be confusion on where the barrier is drawn between health care and social care. One only has to see the balance that is drawn by continuing care funding to see how difficult it is to judge at times. It is also something that is rarely going to be seen to be equitable.
There was a general wide understanding of the most obvious social care provisions like directly provided home care, residential care and day care but this tapers off when provisions like support for those who are homeless or support for substance misuse services or even direct payments for carers are considered.
– Misconceptions about social care funding
When it came to asking about how social care is currently funded there was a large proportion of people who just didn’t know that the services were means-tested. Unsurprisingly, the younger the age of the respondent, the less likely they were to know about how funding was implemented!
Which leads to the third ‘heading’
– Lack of preparation and planning for care needs
The vast majority of people have made no plans to fund future care needs and unsurprisingly, the younger the respondent, the less likely they were to have made plans – or as in the older age groups – feel that they wouldn’t be able to make plans in any case.
– Reluctance towards greater family responsibility for funding and providing care
This heading is an interesting one and one that is a model in other countries but here in the UK, there is seemingly strong resistance to any kind of obligation to fund older family member’s care with only 4% of respondents feeling that there should be an obligation on children to pay for their parents care. 14% would support a system based on means-testing to fund parents’ care however 52% believe that is fundamentally wrong to make any expectations of children to pay for their parents’ care.
Interestingly this resistance to pay increases with age. Perhaps because of closer experiences with the caring role and the need for social care provision.
Also, there was a preferred role for professional ‘paid’ carers providing social care as opposed to family or friends, either voluntarily or in a paid capacity, providing that support.
Although these figures are significantly varied when related to Minority Ethnic families where there is a higher willingness to take up the costs of care for older relatives and a greater desire for that care to be provided by family members.
– Views on the principles for future care and support for a more collective, universal system
When asked about possible models, by far the most popular seems to be a free, universal system of care available to all and funded through taxation on a strictly need basis. I have to say I’m not surprised by this although I wonder if it would change if a proposed level of taxation had been mooted.
– Space for change: a strong desire for more information and debate on the future of social care
With information comes understanding and only 7% of respondents claimed to feel well-informed about the current ways and means that social care is funded, against 69% who feel they are uninformed and 11% who are somewhat informed but would like to know more.
In all I think it’s a study that possibly can link in to the Green Paper proposals – not because there is anything particularly new but because it reiterates the point that there is vast confusion about the current system and will continue to be into the future. People don’t like to think about getting old or needed care until these issues are sometimes quite literally, staring them in the face.
Personally, I can only see some kind of mixed pattern of care with some kind of means testing and some kind of base free entitlement for the most critical needs, possibly with the additional of a type of insurance. The free universal pattern would be wonderful but is not economically viable.
It will be interesting to see what the Green Paper comes up with.
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- Paying for Care (fightingmonsters.wordpress.com)