The Prime Minister has announced his determination to ‘fix social care’ and to create a National Care Service integrated with the National Health Service. I am not an enthusiast for nationalising another aspect of our national life. Estimates vary, but a cost of £18 Billion annually is the choice of a number of commentators.
This expense would come at a time when we already have highest tax burden that we have ever endured, and when our appetite to borrow is viewed with nervousness by our creditors, which is reflected in the higher interest that they are already charging.
This expense would come at a time when we already have highest tax burden that we have ever endured, and when our appetite to borrow is viewed with nervousness by our creditors, which is reflected in the higher interest that they are already charging.
The fact is that, notwithstanding the very high costs of accommodation in care homes, we are not paying enough for social care. It is difficult to recruit staff into the sector because wages and conditions are insufficiently attractive. Providers of domiciliary care are handing back contracts to local authorities because budgets do not cover their increasing costs.
For those with savings above the threshold of £23,250 the principal complaint has been that they have to pay for their social care until their assets fall below the threshold, whilst the impecunious or unfortunate, who have no such savings, have their care costs paid by the taxpayer. Alas, this is an inevitable consequence of any means-tested system. Those without means -for whatever reason- get a free ride on the back of everyone else. The only alternative would be to make free provision for everyone, even the wealthy, at enormous cost to everyone who has to pay taxes.
For those with savings above the threshold of £23,250 the principal complaint has been that they have to pay for their social care until their assets fall below the threshold, whilst the impecunious or unfortunate, who have no such savings, have their care costs paid by the taxpayer. Alas, this is an inevitable consequence of any means-tested system. Those without means -for whatever reason- get a free ride on the back of everyone else. The only alternative would be to make free provision for everyone, even the wealthy, at enormous cost to everyone who has to pay taxes.
What is regarded as the meanest measure, is that often, the expense of going into residential care will require the disposal of a patient’s home in order to pay the bills (although this may be deferred until after death). I’ve never understood why this is regarded as a great iniquity.
The principal way in which British people save is by acquiring property, their home.
We save against the possibility of a ‘rainy day’. Well, the day that you need residential care, isn’t that the rainy day?
In any event, if you have to move into a care home, you will no longer require your own home.
The real source of the anger is the disappointed expectations of the next generation that would otherwise have benefitted from the heritable asset.
You can’t expect to have cake and eat it. We are in the front rank of nations where grown up children no longer live with, or close to their elderly parents. In other cultures, there is much greater reliance on the family for social care.
As we have made a decision not to expect families to care for their elderly, then families should in turn, not expect to benefit from assets handed on unencumbered.
One way to ‘fix’ social care is to find a way of sharing the burden between those who need it, and taxpayers. We did exactly that and we legislated for it: The Dilnot Commission findings, were adopted by Parliament and were due for implementation in 2021 (allowing further time for the public finances to recover). This scheme would have required fees to be capped at £80,000, after which the taxpayer would shoulder the burden. This cap would have incentivised the insurance market to bring forward affordable products to cover that first £80,000 cost.
Unwisely, as it turned out, a new Prime Minister, Theresa May, changed this policy during the 2017 election campaign (at the cost of her majority) and the legislation was subsequently revoked.
Unwisely, as it turned out, a new Prime Minister, Theresa May, changed this policy during the 2017 election campaign (at the cost of her majority) and the legislation was subsequently revoked.
So, we are back where we started, wondering how to fix the problem.