Tag Archives: National Care Service

Coalition kicks social care reform into long grass

The wait is finally over for social care; now we know what the coalition’s plans are for the sector.

Looking at what the government has published – see here for the full rundown – it is a mixture of reform and continuing existing policy.

Firstly, as expected, Labour’s National Care Service plans have been abandoned. This is clear from the announcement that a new commission on long-term care will be established to report back within a year.

I’ve said before that the last thing the sector needs is yet another commission on the future of long-term care. We had that last year with the Big Care Debate, and others previously. Precisely what differences a new commission will find I don’t know. It just seems like a way of kicking the issue into the long grass and delaying some difficult decisions. Again.

Also, the lack of reference to disabled people in the plans – one mention under the Access to Work proposal – shows the main thinking of any reform is geared to older people.

But interestingly, it says the commission will consider several options; not just the Conservative plan for a voluntary insurance scheme, but also Derek Wanless’ partnership model, where the state and the individual both contribute to care costs.

This is significant because when the results of the Big Care Debate came out, the partnership model was most popular among respondents, and some third sector organisations had also publicly backed such a scheme. It also shows that the Tories may be backing away from their widely-derided option.

Elsewhere, the existing personal budgets and direct payments schemes are to be extended, giving more service users control over their care. This is no surprise – it fits nicely with the coalition’s plans to devolve more power to communities as part of their ‘Big Society’ reforms.

Despite rumblings that some social workers are losing faith with personalisation, the extension of it is generally good news for service users who want to take control over their care, and means no significant upheaval for adult social work departments.

Also, as expected, there will be greater integration of health and social care funding, to focus on preventative action, access to respite care will be improved and Access to Work will be reformed.

So, while there are positives in the announcement, the overriding sense is of disappointment. Firstly that disabled people seem to have been overlooked, and that the much-needed reform of long-term care has again been put back until at least next year. The whole sector has been crying out for reform for years, and another commission – to tell us what we already know – does not help. Why can’t the information in last year’s Big Care Debate be used to put together a coalition white paper on social care reform? Or is that too obvious?

A blog on the plans for families and children will also appear later.

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What will new government bring for social care?

After all the courting of the past few days, the Conservatives and Liberal Democrats have finally decided on a political marriage. But what will this mean for social care?

Now the dust is settling, here is a little of what is known, plus some conjecture and guesswork.

Firstly, it means that Labour’s plans for a National Care Service are dead. The Tories always opposed it, and the Lib Dems also had problems with it, so it’s a definite no-go. This means that social care will go back to square one, waiting again for the reform it so badly needs.

On the upside, it looks likely that plans for a set of national eligibility criteria for social care services, proposed by Labour, will be brought in as the coalition parties also both support it. This should end the ‘postcode lottery’ of unfairness in social care and can only be a good thing.

Now, things become less clear; we know there will be big public sector spending cuts in the Budget, which will probably be in June. Both parties have denied that it will hit frontline services, but councils will have to make some big savings and services could be hit – such as scrapping some services that are not perceived to deliver value for money – and eligibility criteria could be ramped up again.

I suspect that a new White Paper on the future of social care may be commissioned in the near future. The Liberals are in favour of (yet another) commission on reforming care funding, but the Tories aren’t, so action may come relatively quickly – we all know the problems in the sector, they just need to be addressed.

Whether the Conservatives’ stated plan for a voluntary £8,000 insurance scheme to pay for elderly residential care comes to pass remains to be seen.

Both parties were relatively light on detail about reform in their respective manifestos, but there were differing ideas, such as the Lib Dem idea of giving all carers one week of respite, so it is hard so say in which direction the government will go.

Also, remember there were the secret cross-party talks about the future of social care earlier in the year – which Andrew Lansley, the new health secretary, scuppered – could anything come out from that?

Hopefully in the coming weeks we will hear something more concrete about what will happen to social care. The sector needs reform quickly, so the coalition needs to work together to find the best solution – whatever that is…

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General election: let battle commence on social care

Finally, one of the worst-kept secrets in the country is officially announced; the general election will be on May 6.

It has been said by many that adult social care will be one of the crucial points on which the election is fought. If so, this can only be a good thing, but only if the public know exactly what they will be voting for and currently, they don’t.

We know Labour’s plans for the future of adult social care; they were in last week’s White Paper. They have outlined plans for a National Care Service, along the lines of the NHS. How it would be paid for is still unclear – but don’t let practical details get in the way of a good policy.

But as for the other main 2 parties – and, in the interests of balance, all the minority parties as well – we know that they don’t think much of Labour’s ideas, but other than that, we know very little about their plans.

The Conservatives have been plugging away with its £8,000 voluntary insurance scheme for paying for elderly care. However, those in the know in the sector don’t believe that this will come up with enough to cover the costs. The Tories disagree. Other than that, we know they favour telecare and a national system of assessment and eligibility for care, and that’s about it.

Meanwhile, the Liberal Democrats want to find cross-party consensus on the way forward in social care, as was being discussed in secret by health ministers earlier this year before Andrew Landsley blew the lid on the meetings. They also want yet another commission to investigate possible ways forward, and have said they would spend £420 million to give carer’s an extra week’s respite – as long as they care for more than 50 hours per week.

I haven’t heard much from any of the minority parties on social care – if anybody knows more, please leave a comment below.

But all this shows that we do not have a full debate on social care – that can only be achieved when others announce their policies and can be analysed objectively against the others.

That is the challenge now for the Conservatives and Liberals – show us your plans and let us decide which way forward is the best for social care.

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White Paper reflections

It is now a day since the White Paper came out, and the response from the media, social care organisations and rival political parties has been quick and, in the main, fairly critical.

The White Paper was given short shrift by most of the mainstream media. While its aims of creating a National Care Service were seen as laudable, many focused on the delays to making changes, how it would be paid for – and by whom – and the lingering “Death Tax”.

Those that gave the White Paper the most enthusiastic welcome tended to be the organisations that are government-backed. To paraphrase Mandy Rice-Davies, well, they would, wouldn’t they?

Charities and third sector organisations seem to have generally given the White Paper a good welcome, but again question where the money will come from for it.

Meanwhile, think tank the King’s Fund – an advocate of the partnership approach before the paper came out – welcomed the ‘ambitious’ plan, but questioned where the money to do it would come from, calling for detailed proposals urgently.

I reckon the King’s Fund was spot-on.

Now I’ve had time to reflect, it seems clearer that the White Paper has been geared to the election – it is big on ideas, but short on detail. Style over substance, if you will.

I really like the idea of the National Care Service – its aims are laudable and it is something to be aspired to. In an ideal world it would be here already.

But – and it’s a big but – I cannot work out how it would be paid for, without having to raise taxes, impose compulsory levies on the public or take money from other budgets. Nether, I suspect, judging by the content of the paper, do the government.

Also, given that the original aim of its preceding green paper was to address the funding of adult social care – with the hope that it would get rid of the current means-testing system – it has singularly failed to do it.

Indeed, the whole question of funding was fudged, with a call for another commission to be set up to investigate the best ways. Evidently the government didn’t want to be associated with any new taxes before the election, so has kicked it into the next parliament.

As a result, the system will creak on, as it has done for years, hated by many. A chance for genuine – and needed – reform of the funding system has been lost, sacrificed at the altar of electioneering.

For me, that clouds all the good ideas contained in the White Paper.

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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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Budget – predictions for social care

What will be in today’s Budget for social care? In the words of magician Paul Daniels, “not a lot”.

The focus has thus far been on stamp duty, fuel duty and measures to help business and stimulate the fragile recovery. It will also be setting the stage for the financial/economic debates in the forthcoming election. Social care hasn’t really had a look in.

From what I can glean, reading around various predictions and what has come from Whitehall so far, the only measure that will directly affect people in receipt of social care is a possible rise in benefits.

While the rises are only expected to be small – 2% on pensions, 1.5% on other benefits – at least the government hasn’t stuck to its usual formula of basing the raise on the RPI inflation rate; last September it stood at -1.4%.

However, I suspect these rises won’t be met with much joy. With the cost of living increasing at the moment – notably food, utilities and fuel – the raise won’t cover it.

Elsewhere, I wonder if the Chancellor will make any reference to the proposed National Care Service or the white paper on adult social care funding – rumoured to be published this week – in his funding plans.

There has been very little mention of this in the pre-Budget build-up, but if the white paper is coming, the Chancellor may give some pointers when he outlines where funds will be going in the coming months.

I will be watching the Budget with interest and will blog and Twitter on this later in the day.

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