Tag Archives: Lord Warner

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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Care funding – at what cost?

As the Free Personal Care at Home Bill creeps its way through Parliament, the voices against it get louder – but yet they still seem not to be heard.

Lord Warner, a former health minister, attempted to get the Bill delayed in a motion to the House of Lords, but lost the vote yesterday.

He said that the government should wait to implement the Bill until it knows what it is doing with the wider review of care funding. That should be in the much-vaunted White Paper, although time is running out for it to be published this side of the election.

Like many others in the sector, Lord Warner also believes the government has got its sums wrong with the policy. For example, ADASS reckons that it could cost local government £500 million, double what is estimated – and pushing the total cost close to £1 billion. If they are right, it could impact on other care services, especially those for people with lower levels of need, as local authorities scramble to find the funds.

The government dismisses these criticisms, saying that the scheme has been properly costed.

Moreover, the Bill still doesn’t address some of the major issues in care and care funding. The plan does not mean that more people will be able to access care services, just that more – that all-important middle class, say cynics with an eye on the election – will be able to access them for free.

Also, it doesn’t address people having to sell their homes to pay for residential care; while they may get free care at home, as soon as they move out they will have to pay.

Of course, as I mentioned earlier, this is only part of the government’s plan for adult social care funding. However, when their full plans are revealed – and those of the Conservatives and Liberal Democrats – I suspect that how they will be funded will be the primary talking point.

In an ideal world, the details of how people will be cared for should be paramount. While it will still be very important – obviously – I suspect that money (or lack of it) will talk the loudest when it comes to choosing new policies. Whether that means we get the best solution for service users is another matter.

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