Tag Archives: costs

Care funding commission must consider all adults

Here we go again. Today sees the launch of the latest Commission on the Funding of Care and Support (catchy title) for adults.

We’ve been here before, most recently with last year’s Big Care Debate. That got as far as a White Paper before the election, but as soon as the government changed the proposals were swiftly dropped. So we’re back to square one. Again.

Nevertheless, the new commission has been detailed to report back within a year. Health secretary Andrew Lansley expects legislation in front of Parliament next year, and it will eventually form part of a larger White Paper that also takes in the Law Commission’s work on creating a single modern statute for social care, and the Government’s vision for social care.

The commission will focus on:

  • The best way to meet care and support costs as a partnership between individuals and the state
  • How an individual’s assets are protected against the cost of care
  • How public funding for the care and support system can be best used to meet needs
  • How its preferred option can be delivered, including an indication of the timescale for implementation, and its impact on local government (and the local government finance system), the NHS, and – if appropriate – financial regulation.

The politicians have, as usual, made all the right noises about this; for instance, Lansley said; “we must develop a funding system for adult care and support that offers choice, is fair, provides value for money and is sustainable for the public finances in the long term.”

All regulation political guff and nothing that anybody disagrees with; it’s just that successive ministers have said this for some years, so its hard not to feel cynical.

But reading between the lines, service users should not get their hopes up that reform will improve things too much. As care services minister Paul Burstow said: “Trade offs will have to be made but we are determined to build a funding system that is fair, affordable and sustainable.”

Trade offs? Is that a euphemism? To me, that is a subtle way of saying that to get to a solution, some existing ways of being funded may have to be axed/cut back. However, this is just speculation on my part – I may be reading too much into it.

But the commission does take place against the backdrop of swingeing budget cuts and this will form a major spoke in their thinking, hence why a leading economist, Andrew Dilnot, has been chosen to chair it.

He will be assisted by the CQC’s Dame Jo Williams and Lord Norman Warner, a Labour peer and former director of Kent social services – and also an outspoken critic of Gordon Brown’s free personal care at home policy earlier in the year – who will help to ensure that the commission does not just focus on the numbers.

As with the last commission, a range of funding options will be assessed, including a voluntary insurance scheme, as favoured by the Conservatives, and a partnership of state and individual contributions, the Liberal Democrats’ preferred option. No mentions of a compulsory levy – aka Labour’s “Death Tax” – being considered in the press release however, so we can assume that that won’t be an option.

But if this is to be successful the commission has to look at funding care for all adults. One of the criticisms of Labour’s last attempt was that it focused too much on older people – especially the voter-winning solution to people having to sell their houses to pay for care – with people with disabilities sidelined.

While older people do make up a significant proportion of those receiving care services, those with disabilities are just as important and any solution has to appreciate their needs and circumstances as well.

The solution also must been seen to improve – or at the very least not cut – services, if it is to get widespread acceptance from the public. Again, this will require doing more with less – a neat trick if you can pull it off.

But what the commission must do above all is to come up with a conclusion. The Big Care Debate had 3 options, but no one option was significantly ahead of the others. This commission should look at all the options and consult widely with frontline workers and service users before making a decision – and then sticking to it.

Coming up with a solution to funding adult social care is not going to be easy – otherwise it would have been done years ago – but this time it needs to happen. However, while some tough choices will have to be made – the financial situation is inescapable – the option of doing nothing is even worse for service users.

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True cost of dementia revealed

If there is one way to make government, and those that hold the purse strings, sit up and take notice of something, it is to put it in financial terms. Especially if the numbers involved are big ones.

So, a figure of £23 billion – the cost of dementia annually in the UK – is bound to have piqued the interest.

This is one of the findings of the Dementia 2010  report from the Alzheimer’s Research Trust, which also reveals that there are 820,000 people in the UK with dementia – a rise of 120,000 on the previously accepted figure.

Usually when these ‘so-and-so costs the UK x each year’ statistics crop up, I take them with a pinch of salt; rarely do you get told how they arrived at their figure, and sometimes you get the feeling they have made it up for dramatic effect.

But in this case, the University of Oxford, which carried out the research, show their working out; adding up the costs of healthcare, social care, unpaid carers and productivity losses, and arriving at a grand total of £27,647 for each person with dementia.

So, with such costs, you would think that research into finding a cure for/preventing dementia would be well funded. Wrong. Dementia research receives £50 million per year, a fraction of the £600 million spent on cancer research, for example, and a drop in the ocean compared to its cost to the economy.

Rebecca Wood, chief executive of the Alzheimer’s Research Trust, has called dementia “the greatest medical challenge of the 21st century.” While that may be slightly hyperbolic, with the number of people with the condition estimated to hit 1 million in the next 15 years, it is certainly an increasing challenge that needs to be tackled.

In financial terms, increasing the research budget is a no-brainer. Even if researchers were to find a drug that just delays or slows the onset – more effectively than those already available – it would save billions.

It is a pretty convincing argument, and one the government should listen to and deliver on. In today’s financial climate, can they afford not to?

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Filed under adult social care, dementia, Social care funding