According to the Daily Telegraph, senior government ministers are close to an agreement on capping care costs. They plan to make this a centrepiece announcement in the coalition’s midterm review in January.
But if the Telegraph reports are correct, the cap will be set at £75k rather than the £35k originally proposed by the Dilnot commission.
A cap of £75k would be pointless (but cheap to government). It would only cover care costs, and not the ‘hotel’ costs of residential care, so older people would have to live in a care home a long time (may be as many as 10 years) before they would get help with their care costs. They would still be faced with the hotel costs and probably would have to sell their home to pay their bills. Which is exactly what Dilnot was trying to prevent.
Also not many older people have £75k readily to hand, so they would be forced to downsize to liquidise their housing asset or they would have to take out an insurance plan to meet the costs.
On top of that, the Dilnot proposals would not bring much-needed extra cash into the underfunded care system to meet unmet needs and the growing demands of our ageing population. The plans would substitute some current spending by individuals with public funding, thereby protecting the assets and inheritances of wealthier families.
Whatever the size of the cap, the Dilnot proposals are fundamentally flawed. They would create a more complex system, which would not be fairer and would not be sustainable given the rising demand for care.
The challenge then for Labour is how to respond. Should it run with a consensus built by Dilnot? Or should it be brave, expose Dilnot as the emperor’s new clothes, and propose a better way forward?
The signs are that Andy Burnham is thinking big. Integrating health and care and building a national health and care service would be a true legacy of Beveridge in the 21st century. It would be a service delivered in or as close to people’s homes as possible. It would promote prevention at all ages and improve quality of life and mental as well as physical wellbeing.
Bringing health and care together would also make better use of tight resources through joint budgets and commissioning and the reduced use of expensive hospital and residential care. But Dilnot would not do this by creating a new funding stream for care that kicks in at the point of crisis.
Labour needs to say how a national health and care service would be funded. There are several options – from radical new taxes on financial transactions to a levy on estates. But key is persuading voters that health and care can be better for everyone.
A simple pledge would be to raise the current means-test threshold from £23,250 to £250,000 – for the same cost as implementing Dilnot but with more impact for low and middle income families. This could be the first step towards a national health and care service.
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Stephen Burke is director of United for All Ages and the Good Care Guide. He is vice-chair of North Norfolk Labour party
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Not sure how your argument works for younger disabled people who are massively penalized if they have unearned income – eg early retirement pensions (from medical retirement), income from lodgers etc. Current system only good for younger disabled ppl whose income derives from work and who only have small savings. So your idea to increase capital threshold is excellent, esp for young disabled ppl who want to save for a deposit on a home, but you need to do more work on the income aspect. Good aspect of Dilnot was lower charging threshold for younger people, with free support for under-40’s – so long as eligibility thresholds and size of budget improved.