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No care, no shame

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The government said it would cap charges on residential care. Now it’s gone back on the promise…

 

 

In their election manifesto, the Conservatives said that by April 2016 they would cap charges on residential social care and limit the liability of any individual needing long-term care, along with a rise in the level of personal assets above which people would be ineligible for state help.

Now ministers have shelved all that for England. Why? Apparently because council leaders, alarmed at the crisis in day-to-day services for elderly and disabled people, asked for the funding set aside for the cap to be used instead to ease the current crisis.

In a letter to health secretary Jeremy Hunt and chancellor George Osborne sent on 1 July, the Local Government Association (LGA) wrote: “It would be deeply damaging to press ahead with a costly and ambitious reform programme if the very foundations of the system we are reforming cannot be sustained.”

A “pause” for the cost cap, due to be introduced next April, was widely expected. The decision was quietly announced in writing at the end of July, just before parliament closed for the summer.

Delaying the cap was tempting for ministers, enabling them to inject up to £2 billion extra into social care in England over the life of this parliament. But it would involve breaking a clear manifesto commitment at the recent general election.

The cap on liability for care costs, set at £72,000 for people above state pension age, was due to be introduced next year under the Care Act 2015, following the recommendations of the Dilnot Commission in 2010.

The intervention by council leaders came in response to what they say is a social care funding gap in England worsening by £700 million a year and forecast to be at least £4.3 billion by 2020. The LGA cited the prospect of paying the “National Living Wage” as one of the reasons for wanting a delay. So young workers are paid a pittance for looking after the old, and “we” can’t afford either decent care or decent wages.

‘So “we” can’t afford either decent care or decent wages.’

As many as 500,000 people who would have been eligible for state help with washing, dressing and meals in 2009 do not receive any support today. According to the charity Age UK, lack of such support in the community means that numbers of elderly – and the number of disabled people stuck in hospital is rising by 19 per cent a year.

In the letter to ministers the LGA stressed that it still backs the idea of a cap on care costs and is not calling for its indefinite suspension, but said that “frank assessments of prioritisation” are needed. The letter continued, “This means considering postponing new costly initiatives – even those we fully support – if that is the only way we can secure sufficient funding for mainstream social care services.”

The letter was signed by Izzi Seccombe, chair of the LGA’s community wellbeing board and Conservative leader of Warwickshire county council, approved by the LGA’s new majority Conservative leader, Gary Porter. So much for election promises!

Savings

On the basis of the government’s cost estimates, postponing the reforms that were due to come in next year will save £590 million in 2016-17. The government will save at least £2 billion in total as implementation will be deferred until 2020, a year after its “austerity” programme is due to end. Annual costs of the care cap changes are set to rise to £2.3 billion by 2025-26.

The Welsh government has already postponed its version of the changes, which were also due to take effect in 2016, because of “uncertainty as to what reform may be introduced in England”.

A one-year postponement in England would have reinstated the original timetable for introduction of the care costs cap. But a delay to 2020 with a hint of rethinking social care provision is likely open the whole debate again, to the detriment of all those needing care now or in the future.

Opinion in the social care sector soon swung behind postponement once the possibility was raised. Ray James, president of the Association of Directors of Adult Social Services, said: “Whilst the Care Act is rightly welcomed across the sector, if asked to choose between implementing the funding reforms right now or having the money to directly fund growing demand for social care, every right-minded person would prioritise a fair and sustainable funding settlement to meet the true cost of providing safe, good quality care.”

Sue Brown, deputy chair of the Care and Support Alliance, representing 80 leading care charities, has blogged that the crisis in social care is so acute that the added demands on councils of introducing the cap “would be dangerous”.

 

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