National Care Service plan slated as ‘too little, too late’

16 Jul 09
A government green paper setting out proposals for a more standardised national system of social care has been questioned by experts and attacked as pre-election posturing by opposition parties.
By David Williams

16 July 2009

A government green paper setting out proposals for a more standardised national system of social care has been questioned by experts and attacked as pre-election posturing by opposition parties.

Shaping the future of care together was launched by Health Secretary Andy Burnham and care minister Phil Hope on July 14. The long-awaited paper proposes a National Care Service for England, in which the government contributes to the provision of care for everyone, not only those with most acute needs and least ability to pay.

Consultation will now run until November, and the resulting system is scheduled to be phased in from 2014.
However, Liberal Democrat health spokesman Norman Lamb told Public Finance that care for elderly people should be a subject for cross-party action. ‘All this can amount to is posturing,’ he said. ‘Far from an attempt to reach consensus and get the process of implementing a new system under way now, the secretary of state is saying this should be an issue for the election.

‘It’s so late in the Parliament – it stands no prospect of ending in legislation. There is a real risk that nothing happens to this, and it ought to be a top priority – that’s the frustration.’

Conservative shadow health secretary Andrew Lansley described the green paper as ‘yet another document long on options and short on costs and conclusions, published late in the hope it will see them through to an election.

‘We don’t need another debate. We need a decision,’ he said.

Local Government Association programme director Corin Thomson said services were being squeezed by a combination of insufficient funding, rising demand from an ageing population and escalating costs resulting from an increase in people affected by conditions such as Alzheimer’s disease.

‘Elements of the green paper will help, and elements of it will damage social care in the future,’ she said, adding that a nationally funded system would ‘hinder the flexibility of councils’ and introduce ‘significant potential to create inefficiency and stifle innovation’.

Thomson welcomed the belated debate but questioned why NHS budgets were apparently sacred while social care remained under-funded. ‘The green paper says it’s important to join care services up with health care but doesn’t touch on the money in the system.’

The government has set out three options, all of which combine government funding and individual contributions.

Under the ‘partnership’ model, the government would provide between a third and a quarter of the cost of care.

In the ‘comprehensive’ system, everybody would be required to contribute 
around £20,000 to a state insurance scheme, and all would have their care fully funded.

Halfway between is an ‘insurance’ proposal, which could enable pensioners to top up the basic entitlement in the ‘partnership’ system by opting into a non-compulsory public insurance scheme.

At present, the average total cost of care is £30,000 – although a fifth of people are expected to pay less than £1,000 for care and another fifth will pay more than £50,000.

The government claims that all three funding options could be brought about by combining existing social care budgets with disability benefits such as Attendance Allowance.

But the green paper proposes splitting off accommodation and food costs from care costs – only the latter would be funded under the NCS. According to Age Concern, that means the government is offering to pay for only 30% of the total cost of staying in a residential home.

A spokesman said: ‘There are a lot of older people who still won’t be able to afford this. Even the comprehensive model is not as comprehensive as it sounds. It still costs £20,000 and you lose your Attendance Allowance.’
Burnham said the NCS would ‘end basic iniquities and inconsistencies’.

Services would still be provided by local authorities, but assessments and entitlements would be the same around the country.        

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