Dilnot caps care contributions in wide-ranging review

4 Jul 11
No one should be required to spend more than £35,000 of their personal assets on care in their old age, according to proposed reforms published today.
By Vivienne Russell | 4 July 2011


No one should be required to spend more than £35,000 of their personal assets on care in their old age, according to proposed reforms published today.


The Commission on Funding of Care and Support, chaired by the economist Andrew Dilnot, this morning set out its recommendations on how long-term care should be paid for.

As well as a cap on individual contributions, the commission recommended that the threshold for means-tested support be raised from £23,350 to £100,000.

People in residential care should continue to pay for their own ‘hotel’ costs, such as food and heating, with somewhere between £7,000 and £10,000 a year given as an appropriate figure.

The cost to the government of implementing the reforms would be around £1.7bn a year, roughly equivalent to 0.25% of public spending.

Dilnot said this was a ‘price worth paying’ given the high degree of fear and anxiety the uncertainties in the current system place on people.

He said: ‘The current system is confusing, unfair and unsustainable. People can’t protect themselves against the risk of very high care costs and risk losing all their assets, including their house. This problem will only get worse if left as it is, with the most vulnerable in our society being the ones to suffer.

‘Under our proposed system everybody who gets free support from the state now will continue to do so and everybody else would be better off. Putting a limit on the maximum lifetime costs people may face will allow them to plan ahead for how they wish to meet these costs. By protecting a larger amount of people’s assets they need no longer fear losing everything.’

Other recommendations in the report include a national set of eligibility criteria, and portability, so that if people move areas they can take their care needs assessment with them; a rebranding of attendance allowance to clarify its purpose; and a government-run awareness campaign to encourage people to plan for later life.

Dilnot said he was ‘confident’ that the government would respond positively to the commission’s recommendations, adding: ‘I expect to be happier and happier as we move forward.’

He stressed that the reforms needed to be implemented ‘with pace’, and expected the government to come forward with a white paper before next Easter.

‘We need to agree what we’re doing and once we agree that, we’ll need to do it pretty quickly, otherwise people will get frustrated,’ he warned.

Health Secretary Andrew Lansley thanked Dilnot and his fellow commissioners for their work on the issue. He said: ‘This is a multi-faceted problem and we know that we cannot look at funding in isolation. We need to take this opportunity to create a system that provides high quality, personalised care and gives people more choice and control over their own care.

‘I now want to engage with those most closely involved in the care and support system to ensure we get these reforms right. I remain fully committed to pursuing reform in this Parliament so people can get the care they deserve when they need it.’

There was widespread praise for the commission’s conclusions. The Association of Directors of Adult Social Services welcomed Dilnot’s recommendations ‘without reservation’.

Adass President Peter Hay said the report ‘signals what will become the moment when adult social care was put on a footing to become fit for purpose in the twenty first century’.

The Local Government Association said the opportunity provided by the report must be seized upon.

David Rogers, chair of the LGA’s community wellbeing board, said: ‘Whatever the finer details may be, reforming adult social care is primarily an issue about funding and this fundamental problem cannot be dodged forever. Collectively we all need to step up to the plate to tackle this and we shall keep urging national political leaders that the time for change is now. Councils are ready to play their part and others have to be too.’

The King’s Fund praised the commission’s report as ‘credible and costed’.

Richard Humphries, senior fellow in social care, said: ‘Where previous attempts at reform have failed due to lack of political consensus, this report offers the prospect of a lasting settlement based on a new partnership between the individual and the state. While we need to study the detail, overall, the recommendations appear to strike a balance between fairness and affordability that all the political parties should be able to support.’

The charity Age UK said the commission’s proposals were ‘ambitious and achievable’.

Charity director Michelle Mitchell said: ‘By setting a clear cap on contributions towards the cost of care, the government would lift the fear and uncertainty for many.

‘The social care system has been neglected for too long and allowed to reach the brink of collapse. The time to act boldly is now to reassure today and tomorrow’s older people.’


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