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.

Small print reveals continuing costs of residential care

So, Conservative shadow health secretary Andrew Lansley has pointed out that the government’s plans for funding residential care doesn’t include the ‘hotel’ costs of it.

For those of us that have followed this closely, this is not a revelation. This debate is about paying for care – board and lodging doesn’t come into it. When the green paper on adult social care funding was released last June, some people in social care pointed out that the proposals wouldn’t mark the end of people having to sell their house to pay for care. Interestingly, at the time, this was largely ignored.

Even in Scotland people in residential care have to pay ‘hotel’ costs – something which isn’t pointed out as often as it should be when people in England moan about ‘free’ care north of the border – and older people do still in some cases have to sell their house to pay for it.

But with the government set to shelve plans for the “Death Tax” this week, according to the Guardian, this seems to be the latest attempt to derail plans for reform.

Again, Lansley seems to be at the heart of this. While this smacks of another attempt at cheap political points-scoring ahead of the looming election, it does raise (albeit in a not-too-helpful way) a legitimate point.

One of the aims of any reform of adult social care funding, according to government messages when the green paper came out, is to eliminate people having to sell their homes. The options listed in the paper didn’t seem to do that.

It is still a problem – many voters see the practice as unfair and penalising those who have worked to own their own homes and leave an inheritance – and if it isn’t addressed many will see any white paper as a failure.

However, the green paper was only a consultation, and the white paper – apparently coming this week – may have a solution. We shall wait and see – and expect Labour’s opponents to seize upon it if it doesn’t.

Blown consensus = blown chances?

So near. And yet, so far. 

In my previous blog, I wrote about how any chance of serious debate about social care and how it is funded has gone, since the Conservatives launched its “Death Tax” poster campaign.

But since then, more has emerged about what was happening behind the scenes before that, and it makes for interesting reading.

I’ve blogged before about how consensus is needed on the future direction and funding of social care and for a while it seems as if the health secretaries of the 3 main political parties had had the same idea.

Apparently, Andy Burnham, Andrew Lansley and Norman Lamb had put party politics to one side and begun working together – in secret, without their superiors’ knowledge – for the good of the country in trying to find consensus on the future for adult social care funding, and had made some progress towards this, according to The Times.

It sounded too good to be true and, ultimately, was.

But the fact that they tried has to be applauded. Social care is such a big issue that it will require support from all 3 sides if a solution to a growing problem is to be found.

It is a shame that this progress was, apparently, sacrificed on the election altar. Whether after this breach of trust the parties will come back together again after the election is a question that will need to be asked.

Little honesty in social care debate

So, the political mud-slinging has begun in earnest. As the Conservatives, Labour and Liberal Democrats all strive to tell you how bad the others are (or would be), reasoned debate goes out of the window.

The Tories have landed the first blow, accusing Labour of planning a £20,000 “Death Tax” to be levied on all estates after death.

To ram the point home, a new poster was revealed depicting a gravestone engraved with ‘RIP Off’ (see what they did there?) and the slogan: ‘Now Gordon wants £20,000 when you die.’

Health secretary Andy Burnham has rejected this accusation (or hinted that the party is planning it, depending on which paper you read), saying that “firm proposals” will be set out before the election – one assumes he means the White Paper on adult social care funding, which is still being promised, although time is fast running out if it is to appear before the election.

Currently, Labour is sticking to its line that it is considering the outcomes of the Big Care Debate, which took place last autumn after the release of the green paper on the future of adult social care funding.

The Conservatives have said even less, apart from their £8,000 voluntary insurance scheme.

Responding to this, another other related stories, Stephen Burke, chief executive of Counsel and Care, a charity that works with older people, their families and carers, has appealed for an “honest and serious” debate that recognises that better care will cost more, and that radical reform and proper funding is required.

While many people in the social care sector will agree wholeheartedly with that call, the chances of such a debate happening are virtually nil.

Also, any hopes of a cross-party consensus on the future of social care – something various social care commentators have called for – now appear dead and buried.

With the parties now getting into the swing of electioneering, everything they say will be geared to getting your vote. So a reasoned debate on the future of care funding will not happen, because it will require some tough – i.e. not popular – decisions to be made, if a crisis of care is to be averted. No politician is going to say anything that might lose them votes.

Queen’s Speech not enough for social care bodies

While the announcement of free personal domiciliary care for those with the greatest need was a central point of today’s Queen’s Speech, finding anyone with a positive outlook on it is difficult.

The combined weight of anti-government feeling and deep-rooted cynicism in the care sector means that the policy has been given a lukewarm response at best.

Critics cite a number of problems that haven’t been properly answered. For example, many question the costs involved; it is said to cost £670 million a year, but nobody seems to believe that. Also everyone wonders where the money for that is coming from – woolly references to ‘costs savings elsewhere in the NHS’ don’t cut it. Some also suspect councils will start to get tougher on what exactly constitutes ‘substantial and critical’ needs in a bid to save money.

It also doesn’t address the media’s perennial favourite topic of people having to sell their homes to pay for residential care. Health minister Andy Burnham admitted on Radio 5Live this morning that when someone needs to move into residential care, they will have to pay for that as they would within the current system.

It is, as Labour admits, an interim measure before the full adult social care white paper is published – but no-one quite knows when that will be, or indeed if it will get published.

The cynic in me wonders if this is just an early bit of electioneering, attempting to embarrass the Conservatives if they decided to ditch the policy, and painting Labour as a ‘caring’ party.

Indeed, whatever the pluses and minuses of this policy, it is still unlikely to make it onto the statute book before the election comes – there are only 70 working days left before the election and Tory peers have vowed to hold up legislation in the House of Lords, if it gets there.

While the idea is good – it could help 400,000 people – it does not solve the social care problem, and this seems to be one of the big criticisms. Social care needs a radical overhaul, and this only goes a relatively small part of the way. The next government – whichever party it is – needs to go much further.