25 April 2008
People should be compelled to save for social care in their old age as part of a social insurance model, an NHS Confederation paper argues.
As access to funding for personal care is means tested, many older people have been forced to sell their homes or other assets to pay for help or a place in a care home. But Funding tomorrow today, published this week, says this is not sustainable.
It adds that it is unrealistic for a rising elderly population to rely on its children to fund social care through taxation.
The current system did not help all those who could benefit from it – most local authorities (70%) provide care only to those with a substantial or critical need and with assets of less than £21,500.
Social care would not survive without a new model, in which the state guarantees a 'sensible' level of care, it says. The better-off could then top up their care from their social insurance, while the poorest would receive government support. This would be fairer, would remove the disincentive to save and would favour prevention over high-cost 'last resorts' such as care homes.
The users would have control over how the money was spent rather than the funders of care.
The social insurance model worked well in other countries, such as Germany and the Netherlands, the paper says. In the latter, employees paid 12% of their salary for a defined range of benefits.
The paper is the first in a series of documents designed to spark debate ahead of the confederation's annual conference in June.
Chief executive Gill Morgan said the country had to face up to the problem. 'Decisions around the care of the elderly and the long-term sick cause genuine heartache for frontline NHS staff,' she said.
'A system of social insurance that guarantees a level of care to the elderly and sick in keeping with the NHS's values of fairness and social justice – with top-ups for those who can afford it and support for those who can't – offers a fairer way forward.
'We do not claim this paper is the only answer or indeed the right answer,' she added.
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