Posts Tagged ‘Dilnot’

We need to have an honest conversation with the public about social care

28/09/2021, 10:07:45 AM

By Joanne Harding

This piece is part of a new book “Labour’s Reset: The Path Back to Power” which is being released today. The book looks at the barriers for voters in picking Labour, what the party can do in opposition to tackle these issues and the type of policy platform that would attract switchers to Labour at the election.

‘If you neglect physical infrastructure, you get roads full of potholes and buckling bridges, which prevent your economy functioning properly. The same is true if you fail to invest in social infrastructure.’ These  were the words Liz Kendall used as she addressed a conference of directors of social care back in April this year. I think we can all agree that social care has been neglected by successive governments for years. The question is what could and should Labour do to truly address what I believe to be one of the most difficult policy challenges of our times. One of the fundamental issues with social care is that people do not really understand what it is. It is incredibly difficult to define as it ranges from supporting a person to wash and eat, to administering medication, to safeguarding, protection of liberty and to end-of-life care. It is inextricably linked with health by virtue of some of the elements of personal care, yet it is so much more than health.

However, it does not have the same branding as the National Health Service (NHS) that we all recognise and hold dear to us as a beacon of all that is good. Politicians talk about health and social care, yet they continue to leave it out in the cold when it comes to policy and funding conversations. This lack of focus on social care is reflected in public attitudes – in polling conducted by Yonder for Labour Uncut, when respondents were presented with a list of 11 different policy and just 6% of voters picked social care as the highest priority.

It does not attract the same attention as a hero workforce and life-saving and ground-breaking treatments do. Nevertheless, make no mistake about it, social care encompasses every single one of these things and more.

Labour therefore has a role to play in changing the narrative among its members and the wider public. Maybe then, we can have a more honest conversation about the areas I feel we need to tackle if we are to reform and transform social care.

Funding reform

This will surely be considered the most contentious and difficult element of our policy work. If we truly want a publicly funded social care system in England, we need to establish how we are going to pay for it. Projected  growth on spending for social care is simply not in line with predicted growth pressures, which are rising at 3.7% annually in real terms. More than 1 million people aged 65 or over will require varying degrees of social care support by 2035; this is up from 783,000 individuals in 2015. As people live longer and advances in medicine and assistive technology support people to live with chronic and long-term health issues, greater strain will be put on an already creaking system.

We know we cannot simply stand still as we will have a predicted gap of £3.5 billion to fill by 2025 to maintain our existing standards of care, which are frankly failing too many people. Age UK reports that 1.5 million people living in the UK have an unmet care need and if current trends continue, this could grow to 2.1 million. Furthermore , the government have offered  short-term bungs over the years to paper over the cracks. Relying on a council tax precept and business rates cannot possibly be a sustainable funding model for an infrastructure that is so vital to a healthy society. It also creates inequity in local authorities that will be living with greater health inequalities and higher levels of poverty. Current provisions are  truly a postcode lottery.

Johnson’s statement to the House of Commons last week has done nothing to reassure those of us who live and breathe social care that reform is coming anytime soon. The  majority of the income generated by a regressive national insurance rise will not really go towards funding social care. For three years, all of the money will go towards easing the NHS backlog; in fact, only £5.4 billion of the £36 billion will head in the direction of social care. Councils may well be forced to raise council tax yet again in order to meet demand. Social care is in crisis right here, right now. The Tory Party’s talk of funding and reform are actually just warm words.


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Can trees really be more “sexy” than people?

07/07/2011, 08:49:18 AM

by Peter Watt

Prepare to be bored. This post will probably not particularly interest you. At a push, it may strike you as being earnest, but quite frankly, not very sexy. It doesn’t slag anyone off. It doesn’t condemn the leadership and it doesn’t insult Nick Clegg or a single Tory. It does though raise an important issue of social justice and fairness.

On Monday, just before the appalling revelations about the News of the World, hacking and Milly Dowler broke, and understandably dominated the headlines, the Dilnot report, “Fairer care funding” was published. It is the final report of the commission on funding of care and support, which has spent a year looking at how we can pay for the care of vulnerable adults over the coming years. It is a massively important and well-crafted report that sets out a realistic financial model of how we can pay for the costs of an ageing society in years to come. I have written about this issue before, because the status quo simply cannot continue – the system as it is, is broken.

Labour needs to take a fair bit of responsibility here. After all, we had thirteen years to fix the system and didn’t. We had a number of our own reports and commissions and then we quietly buried their conclusions. You can understand why. It is a brave politician indeed that stands up and says to the public, “You know that you think that the NHS will look after you when you are unable to look after yourself, well actually it won’t and in fact it never has”. But, as research undertaken by Dilnot makes clear, the truth is that people do assume that. And it really isn’t something that you spend a lot of time worrying about when the issue doesn’t affect you.

The cold hard reality is that the costs of paying for social care are, on the whole, borne by those that need the help. So if you need hot meals delivering, help at home, a few days a week at a local day centre or to move into residential care and you have more than £23,250 in assets, then you have to pay. Your savings are used up, your family may have to chip in and your home may be sold so that you can receive the care that you need.

With local councils’ budgets being tight, you have to be pretty infirm to be able to get any help provided at all. If you think that you need help, then your local authority should first carry out an assessment to determine how infirm that you are. This assessment will categorise your needs as being low, moderate, substantial or critical. Generally they will only help if your needs are substantial or critical. You will then be assessed financially and it will be determined how much, if any, of the help you are entitled to will be paid for.

If you need help and live in a home that you own, your assets will clearly exceed £23,250.  And just to bring it life, “moderate need”, for which you are very unlikely to get any help at all, means that you may not be able to get to the shops, bath or shower or get out to meet your family or friends independently.

Suddenly finding that you or a loved one needs help either at home or residential care can be frightening, stressful, emotional and financially catastrophic. Help at home can cost between £10 and £20 per hour. The average cost of a room in a nursing home is £36,000 per year. The bills really do start to rack up quickly.

So back to Dilnot. These are not proposals for the state to pay for everything. The commission accepts that individuals should contribute something from their own assets towards the cost of their care and accommodation. Instead, there is a proposal for a partnership between the state and individuals that removes the uncertainty. Under the proposals, we will each be responsible for meeting some of the costs of our care but the extent of our exposure will be capped at £35,000. The capital limit will be raised from £23,250 to £100,000. After that the state will kick in and pay the rest.

The proposal means an extra £2 billion or so in spending by the state a year, about 0.25% of public spending. And for that we get peace of mind that in our old age we won’t face the fear and uncertainty of not knowing how much or who will pay if we need it. Most people will still pay something towards their care. But for that £2 billion we can ensure that those with modest means will not be unduly penalized following a life of hard work and saving. And we can ensure that the poorest are protected.

It might not be at the sexy end of politics. But it matters. Right now the government is deciding on what to do with the recommendations. To be fair to them; it is a tough call. Like any balanced proposals, there are elements that will both appeal and repel the various strands of political opinion. And that is why we should all be helping to persuade them that this is not about party politics or point scoring. It is bigger than that.

Ed Miliband has promised to enter into all party talks and that is to be hugely welcomed. But we should all be writing and emailing our MPs to say that the government should, after considering and consulting, support and implement the commission’s findings as soon as possible. When there was a proposal to privatise a small proportion of the national forests there was uproar. Hundreds of thousands lobbied their MP. It sent a signal. Well this isn’t about trees; it’s about people. And that same uproar sadly appears lacking.

At the moment the government is promising a white paper by the spring. If the timetable slips, then it will be a sure sign of prolonged delay. Right now people are suffering, frightened and uncertain about their future because of a broken system. This is an opportunity to fix it.

Peter Watt is a former general secretary of the Labour party.

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Monday News Review

04/07/2011, 06:04:55 AM

A care revolution

The Dilnot Report will suggest an overhaul to the system which is intended to benefit Britain’s ageing population. Under the current system elderly people only start to receive state support when they are down to the last £23,250 of their assets. People would instead pay up to a capped amount – expected to be around £35,000 – before state-funding kicks in. It’s possible that a tax rise or further cuts in public spending would be necessary to pay for this. Estimates suggest the proposals would cost the Treasury £2bn at the start before rising further. Experts estimate that a maximum liability of £50,000 could be insured for a one-off premium of around £17,000 on retirement. The report has partly sought to make clearer the burden of cost facing the elderly so people can prepare and save for it during their working life. Charities working with elderly and vulnerable people have cautiously welcomed the report and suggest changes are long overdue. The Labour leader Ed Miliband has publicly offered to hold talks with the Prime Minister to achieve cross-party agreement on the proposals. The government is not expected to make any changes immediately, instead weighing up the best course of action and deciding who will pay and how. The current system of support for the elderly is widely regarded as a lottery, as one quarter of 65-year-olds will not need to spend significant sums on care, while another quarter will face bills of more than £50,000 and one in 10 – often those who spend long periods in residential homes suffering from dementia – will have extensive needs costing more than £100,000. Some 20,000 people a year are thought to sell their homes to pay for care. – Sky News

A long-awaited shake-up of the way elderly people contribute to their care home bills will be announced today. The report is expected to ­recommend OAPs should pay no more than £50,000 towards their stay. The Treasury would pick up the rest of the bill – meaning fewer people will be forced to sell their homes. Care would remain free for those with very few savings or assets. But millions of people will be urged to take out insurance costing up to £17,000 to cover care fees. The measures drawn up by Andrew Dilnot are seen by many as the last best hope to pay for our growing elderly population. Health Secretary Andrew Lansley yesterday signalled the measures could come into force by the end of Parliament in 2015. But there are fears the £2billion-a-year cost of the plans could see Chancellor George Osborne strangle the proposals at birth. Labour leader Ed Miliband said: “The last thing Britain needs is for Andrew Dilnot’s proposals to be put into the long grass. We three party leaders are of similar age and the same ­generation. This is a once-in-a-generation opportunity which our generation must address.” – Daily Mirror

Local councils are poised to take on a major financial services role under proposed reforms to be unveiled on Monday of the funding system for the care of elderly and disabled people. Under the scheme, local authorities will be empowered to make a loan at a preferential rate against the value of a property owned by someone entering a care home. The loan would be redeemed on the sale of the property after the person dies. The plan is part of a series of ideas drawn up by a government commission led by the economist Andrew Dilnot. The proposals seek to inject more funding into the care system by tapping into people’s assets. The typical 55- to 64-year-old in the UK has a total wealth of £200,000. Although the centrepiece of Dilnot’s report will be a recommended cap of about £35,000 on individual liability for care costs, which would require underwriting by the government, other proposals will seek to make it easier for people to draw on their assets without having to sell their home during their lifetime. According to the Joseph Rowntree Foundation, about a million elderly homeowners have properties worth more than £100,000 yet qualify for means-tested benefits. Charities and welfare groups are calling on the government and Labour to seize the opportunity presented by Dilnot to begin a shakeup of the care funding system. An open letter from 26 leading charities declared on Sunday: “We expect all parties to deliver on this.” Ed Miliband, the Labour leader, has reiterated his offer to engage in cross-party talks on the Dilnot proposals with an “open mind”, setting aside his party’s previous policy of a national care service. – the Guardian

Goldsmith gloats

Ed Miliband’s faltering leadership suffered a fresh blow yesterday as a close ally of Tony Blair warned it was ‘not clear what he stands for’. Former Attorney General Lord Goldsmith launched a withering attack on the Labour leader, warning that nine months after his election he still has to ‘prove himself’. He said the party’s Blairites were ‘standing back’ to give Mr Miliband a chance. But asked whether the Labour leader was connecting with the public said: ‘He doesn’t at the moment. It is not clear what he stands for.’ Shadow Home Secretary Yvette Cooper – seen by many at Westminster as a future Labour leader – yesterday insisted that Mr Miliband’s leadership was not ‘faltering’. She said he was doing a ‘good job’ but urged critics to give him more time to impose himself and connect with the public in the wake of last year’s election defeat. Lord Goldsmith’s intervention came amid reports that the Blairite, ex-Cabinet minister James Purnell was being urged to return to Parliament to help rescue Labour from the leftwards drift seen under Mr Miliband. – Daily Mail

Lord Goldsmith suggested Mr Miliband was harming Labour by excluding major figures from the Blairite wing of the party. He named former minister James Purnell, who quit as an MP last year, as a “loss” and “potentially a very important figure in the party”. It came amid reports that Mr Purnell – who quit the Cabinet in 2009 in a failed bid to oust Gordon Brown and now heads a think tank – is being urged by figures close to Mr Blair to return to Westminster to stave off another election defeat. Lord Goldsmith, who was Attorney General under Tony Blair, said he did not believe the rifts had been healed between Left wingers seen as loyal to Mr Brown – such as Mr Miliband – and those from Mr Blair’s camp. “I think people are standing back, letting Ed Miliband have an opportunity to prove that he can do it – and that, at the end of the day, is what matters,” he told Sky News’s Murnaghan programme. Asked if the Labour leader was connecting with voters, he replied: “He doesn’t at the moment. It is not clear what he stands for.” The question, he said, was whether Ed Miliband had healed the Blair-Brown split and “whether there are enough Blair heavy hitters in his shadow cabinet”. He went on: “I think many of us would like to see more of them back. There are very powerful figures still able to help Ed Miliband and they are being excluded and that is a problem.’’ – Daily Express

Huhne under increased pressure as son’s phone becomes evidence

Chris Huhne’s former marital home has been raided as part of a police investigation into allegations he persuaded his wife to take responsibility for a speeding offence that he had committed so he could avoid a driving ban. Officers from the Kent and Essex Serious Crime Directorate visited the home in Clapham, south London, where the Energy Secretary’s former wife, economist Vicky Pryce, lives. They confiscated the mobile phone of the pair’s son, Peter, 18. The phone is alleged to contain an exchange of text messages between Mr Huhne and his son in which the pair discuss the investigation into the March 2003 speeding offence. – the Independent

Pressure was mounting on Chris Huhne last night after it emerged that police raided his ex-wife’s home and seized his son’s mobile phone. The Cabinet minister is fighting for his political career over claims he persuaded Vicky Pryce to accept a speeding conviction on his behalf. Detectives with a search warrant raided Ms Pryce’s £2million home at 7am, woke 18-year-old Peter and asked him to hand over the mobile, which reportedly contained a text message exchange in which the pair discuss details of the case. Energy Secretary Mr Huhne currently has the backing of Lib Dem leader Nick Clegg but insiders say patience is running out due to the constant trickle of stories about him. Ms Pryce, 57, told friends of her shock when the three Essex Police officers turned up unannounced at her South London home. Mr Huhne, 56, denies persuading her to take three points for him but a photograph of her licence shows an endorsement for speeding on March 12, 2003 – the date his car was allegedly caught on camera. Relations between the couple broke down when he left her for media consultant Carina Trimingham last year. – Daily Mirror

It’s that lady again

Voters rate Margaret Thatcher the most capable Prime Minister of recent decades, but Tony Blair was the most likeable, according to a poll. Only ten per cent regarded David Cameron the most capable and 17 per cent the most likeable. Current Conservative voters overwhelmingly preferred Lady Thatcher, with two-thirds saying she was the most capable compared with one-fifth for Cameron. Overall, 36 per cent of those questioned said Thatcher – Tory Prime Minister from 1979 to 1990 – was the most capable leader of the past 30 years. She was followed by Mr Blair on 27 per cent, Gordon Brown on 11 per cent, Mr Cameron, ten per cent and Sir John Major, seven per cent. When asked about likeability as a person, some 26 per cent put Mr Blair first, followed by 22 per cent for Lady Thatcher, 17 per cent for Mr Cameron, 13 per cent for Mr Brown and ten per cent for Major. – Daily Mail

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