Tag Archives: adult social care white paper

Adult social care White Paper: good points but short on funding detail

For all Andy Burnham’s fine words about following in the footsteps of Bevan and establishing a National Care Service, the White Paper – Building the National Care Service – doesn’t address the main problem with social care – and the original purpose of the green paper last year: how it is paid for.

But first, the good points:

The proposals for a National Care Service – free at the point of use, given according to need, with the principles of being universally accessible, having a strong national framework locally delivered, being preventative and flexible, with support for carers, and information and advice for all – is admirable.

Social care has – as the government admits – lagged behind other sectors, such as healthcare in terms of provision. It has never had a national structure and one is well overdue. It is hard to argue with the government’s aims here.

The commitment to put in place nationally consistent eligibility criteria for social care – enshrined in law – is one that many have been crying out for. The ending of the postcode lottery will go some way to addressing the perceived unfairness of the current system.

Likewise, ensuring accurate, relevant and accessible information about what people are entitled to, how the assessment process works and how to access care services is provided to everyone, and improving the gateway for accessing social care and disability benefits to make it simpler and easier for people, are also welcome and long-overdue developments.

Keeping Attendance Allowance and Disability Living Allowance also shows that the government has listened to some outcomes from the Big Care Debate – getting rid of this would have proved very unpopular.

The continuing commitment to the personalisation agenda – in giving service users choice and control – will also be welcomed by the majority, not least social workers who may have feared yet more upheaval.

But on the downside…

It also talks about people in residential care only having to pay their own fees for 2 years. Fine, but the average time spent by an older person in residential care is 3 years, so they would only get one year ‘free’.

Also, while people in residential care would still have to pay their accommodation costs, there is a commitment that no-one will have to sell their house to pay for care within their lifetime. With a deferred payment plan, their family may have to pay for it out of their estate after their death.

This leads neatly to the crucial bit – and one I suspect made with an eye on the election – no decision on the funding of the National Care Service will be made until 2015 at the earliest. Not so much kicking it into the long grass but the jungle.

This is where the White Paper falls down. The social care sector has been creaking along with the much-hated means testing system for years. It is widely accepted that the system needs reform – mostly because it is too complicated and perceived as unfair in some cases – and while it says it will address this, it doesn’t say how.

The government still leans towards some sort of compulsory levy – which means the so-called “Death Tax” isn’t dead – but is not specific on what. Indeed, they have called for a new commission to look at when and how the fee should be applied, and how much it should be. But wasn’t that the original aim of last year’s green paper?

However, in fairness, there wasn’t a great deal consensus on funding. Andy Burnham revealed that, of the 3 funding options outlined in the green paper, 35% favoured a partnership approach, 22% opted for an insurance model, while 41% backed the comprehensive approach.

Meanwhile, the Conservatives are still talking about their £8,000 voluntary insurance scheme to pay for all this. As mentioned before, this doesn’t seem to be enough and I doubt enough people will sign up to it, knowing it is something they may not need in the future.

So, much-needed reform is on the way for the social care sector. While the proposals are great in principle, I can’t help but worry how all this will be paid for – there is precious little on that.

Also, the lack of political consensus on this – the Tories branded the White Paper a ‘train crash’ in today’s Daily Mail – means that after an election we could be back to square one again.

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What will be in the white paper?

After what seems like an eternity, the adult social care funding White Paper will finally be published tomorrow. So what will be in it? Here is my bit of crystal ball gazing…

Firstly, it will lay out Labour’s plans for a National Care Service that provides clear national entitlements for everyone, rather than the current postcode lottery. This was first mentioned in last year’s green paper and the idea at least was widely welcomed. The White Paper should flesh out exactly what that might entail and the funding for it.

The free personal care at home policy will also be in there. This has been championed by Gordon Brown and there isn’t a chance it will be dropped now, although the timing of its introduction may be put back until after the election.

In terms of funding, I expect that a ‘partnership’ model – where the state pays a portion of care costs and the service user pays the remainder – will be proposed. In the debate over funding, this seems to have garnered the most support and is something of a ‘middle’ way – and less politically divisive than, say, putting a levy on the estate of every person.

That option is a non-starter because the Conservatives branded it the “Death Tax”. Leaving aside whether it is a good idea or not, the negative publicity already around it would make implementing it political suicide.

Funding will probably be the most controversial part of this; while it is widely accepted that the current adult social care system needs to change, funding it is the tricky bit. For instance, the free personal care at home policy has been consistently lambasted because nobody believes the government’s estimate that it will cost £670 million – some say it could be more than £1 billion.

In addition, setting up a National Care Service, and contributing to everyone’s care costs, will cost billions. In a time where government departments – including the Department of Health – are scrabbling around trying to save billions, you wonder where the money would come from.

And then there is the election. The white paper will probably become a large spoke of the election campaign, which will be a bad thing. As I’ve mentioned previously, cross-party consensus is needed if the best solution for the public is to be reached. With an election, and all the ‘our policies good, your policies bad’ mudslinging that comes with it, this is out of the question.

Of course, the election also means that the White Paper may come to nought if Labour is ousted from power. The Tories have suggested they may go for another consultation before they do anything. If there is a hung parliament, who knows what will happen to it?

So, with that in mind, tomorrow’s White Paper may make promises, but it is by no means certain that essential reform will come to the sector just yet.

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