By Helen Mooney
1 October 2009
Prime Minister Gordon Brown has been accused of trying to pull a ‘rabbit out of a hat’ in announcing that the government will offer free personal care so frail elderly people can be cared for in their own homes.
In his speech to the Labour Party annual conference on September 29, Brown said that some 350,000 people with ‘the highest needs’ would receive home care regardless of personal wealth from October 2010.
But Niall Dickson, chief executive of health think-tank the King’s Fund, said that the new proposals would have to be squared with those in the social care green paper, which the government is consulting on. ‘It does seem slightly odd to produce this rabbit from a hat just as the debate is getting under way,’ he said.
Currently no-one with savings over £23,500 receives state assistance. The new provision will apply to people in England who require assistance with every aspect of day-to-day living, from dressing to cooking, but it will not apply to those in residential care. The cost would be retrieved from low-priority areas of the NHS budget, including marketing and communications, the Department of Health indicated.
Brown said: ‘The people who face the greatest burden are too often those on middle incomes who have savings which will last a year or two but then they will see their savings slip away. So I can say today that for those with the highest needs we will now offer in their own homes free personal care.’
The prime minister’s move was strongly backed by Health Secretary Andy Burnham in his conference speech on September 30. He said the so-called ‘National Care Service’ would offer ‘a fairer and better quality care system, where everyone gets some help, where staff are properly rewarded, giving peace of mind in retirement’.
He added: ‘Families face the pain of seeing loved-ones decline, whilst fighting a daily battle with the system to get help and seeing everything they have worked for whittled away. It's the biggest social unfairness of these modern times.
‘Politicians have ducked reform because the options are tough. But to leave it alone, letting people fend for themselves, means we fail another generation of older people – the post-war generation soon to reach 70, who unlike their parents, own their homes outright. I don't want that for my parents, nor anyone else's.’
But Dickson expressed reservations about the initiative. ‘The government estimates this will cost £670m and benefit 350,000 older people. There is a danger that local authorities will have a perverse incentive to encourage people into residential care where many will still have to pay out of their own pockets.’
Andrew Cozens, strategic lead on adult social care at the Local Government Association, told Public Finance that it was unclear what Brown’s pledge would mean in practice.
‘I think that there is no doubt that charging for domiciliary care has always been unpopular with service users and quite difficult politically, but there will be a complexity to this. I would also be very keen that there are no perverse incentives which could restrict people’s access to NHS services like we have seen in the continuing care debate.’
Meanwhile, figures published on September 30 by the NHS Information Centre show a £791m increase gross spend for adult social care services in the last year to £16.1bn.
Local authority spend on older people (aged 65 and over) has also increased, from £8.8bn, to £9bn in 2008/09, an increase of 4% in cash terms and just over 1% in real terms. Spending on residential care was up in cash terms from £7.39bn in 2007/08 to £7.59bn in 2008/09.
1 October 2009
Prime Minister Gordon Brown has been accused of trying to pull a ‘rabbit out of a hat’ in announcing that the government will offer free personal care so frail elderly people can be cared for in their own homes.
In his speech to the Labour Party annual conference on September 29, Brown said that some 350,000 people with ‘the highest needs’ would receive home care regardless of personal wealth from October 2010.
But Niall Dickson, chief executive of health think-tank the King’s Fund, said that the new proposals would have to be squared with those in the social care green paper, which the government is consulting on. ‘It does seem slightly odd to produce this rabbit from a hat just as the debate is getting under way,’ he said.
Currently no-one with savings over £23,500 receives state assistance. The new provision will apply to people in England who require assistance with every aspect of day-to-day living, from dressing to cooking, but it will not apply to those in residential care. The cost would be retrieved from low-priority areas of the NHS budget, including marketing and communications, the Department of Health indicated.
Brown said: ‘The people who face the greatest burden are too often those on middle incomes who have savings which will last a year or two but then they will see their savings slip away. So I can say today that for those with the highest needs we will now offer in their own homes free personal care.’
The prime minister’s move was strongly backed by Health Secretary Andy Burnham in his conference speech on September 30. He said the so-called ‘National Care Service’ would offer ‘a fairer and better quality care system, where everyone gets some help, where staff are properly rewarded, giving peace of mind in retirement’.
He added: ‘Families face the pain of seeing loved-ones decline, whilst fighting a daily battle with the system to get help and seeing everything they have worked for whittled away. It's the biggest social unfairness of these modern times.
‘Politicians have ducked reform because the options are tough. But to leave it alone, letting people fend for themselves, means we fail another generation of older people – the post-war generation soon to reach 70, who unlike their parents, own their homes outright. I don't want that for my parents, nor anyone else's.’
But Dickson expressed reservations about the initiative. ‘The government estimates this will cost £670m and benefit 350,000 older people. There is a danger that local authorities will have a perverse incentive to encourage people into residential care where many will still have to pay out of their own pockets.’
Andrew Cozens, strategic lead on adult social care at the Local Government Association, told Public Finance that it was unclear what Brown’s pledge would mean in practice.
‘I think that there is no doubt that charging for domiciliary care has always been unpopular with service users and quite difficult politically, but there will be a complexity to this. I would also be very keen that there are no perverse incentives which could restrict people’s access to NHS services like we have seen in the continuing care debate.’
Meanwhile, figures published on September 30 by the NHS Information Centre show a £791m increase gross spend for adult social care services in the last year to £16.1bn.
Local authority spend on older people (aged 65 and over) has also increased, from £8.8bn, to £9bn in 2008/09, an increase of 4% in cash terms and just over 1% in real terms. Spending on residential care was up in cash terms from £7.39bn in 2007/08 to £7.59bn in 2008/09.
