Capping long-term care costs at £75,000 betrays the spirit and the letter of the Dilnot proposals. Only a handful of older people stand to gain
Three years ago the BBC created a ‘care cost calculator’. You could use it online to work out how much you would be likely to have to pay towards residential and nursing home care if you ever needed it. Now we know that the coalition government has been tapping figures into its own political calculator.
It wanted to work out at what level it should cap the payments for care required from people with assets before the state picks up the bill. The target set seems to have been that very few people should be helped and very little money should be committed to covering care costs.
I was initially excited this week that the issue of the funding of care for older people was being dragged out of the political long grass. I was also excited that the model proposed by the Dilnot Commission two years ago was now accepted as a fair and affordable way to share the risk of the costs of long-term care between individuals and the state.
My preference might have been truly pooling and sharing risk across the total population by funding care through national taxation or national insurance. When I led consultations about previous government green and white papers on care this was what the majority of those who participated said they also wanted.
But no major political party now seems willing to make a commitment to progressive taxation as a means of covering care or any other costs.
My albeit somewhat restricted excitement that the care cost challenge was about to be met by the government accepting the Dilnot proposals has been short-lived. Dilnot proposed that older people should have to pay the first £30,000 of their care costs, and should continue to pay for all of their board-and-lodgings, but care costs beyond £30,000 would be met by the state.
Cameron and Clegg have announced, however, that they are looking to set the care cap at £75,000. What this means is that the great majority of older people in residential and nursing homes will never get any benefit from a cap set this high as they will have died before their care costs (minus board-and-lodging costs) cross this threshold.
Is a lower threshold affordable? Of course it is. It is a matter of political priority and choice about how much to tax and where then to spend. Paul Burstow, until recently the care minister, has noted that means-testing winter fuel payments to people over 60 would provide the money to fund the Dilnot proposals for a much lower cap.
Read on the web today’s responses by Mail and Express readers to the now intended £75,000 care cap. They are not happy. Comments such as ‘absolutely disgusted’ and ‘Cameron soaks the middle class and gives the money to the super rich’ are not untypical, and this from readers of Conservative-supporting papers!
It does seem that the political calculator used by Cameron and Clegg may need a new battery. It has come up with a care cap which has pleased hardly any one and alienated even their own natural supporters. It may have lifted the issue out of the long grass but only to bury it in a pit of practical irrelevance for most people who have to pay for care.
But there is an even bigger issue. What if you have no assets at all, having been a carer with no paid employment or been in low paid or insecure employment, and are dependent on your local council to pay for your care?
The government is dramatically cutting council funding. You are unlikely to get the care you need until you are absolutely desperate and in deep trouble. This though seems to be beyond the remit of the hand-held battery political calculators now in use. Roll on the invention of a new generation of really powerful political computers programmed to promote fairness and compassion.
Ray Jones is professor of social work at Kingston University and St George’s, University of London, and from 1992-2006 was director of social services in Wiltshire.
