Magazine article Public Finance


Magazine article Public Finance


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Faustian pact over care cap

Discussions about the 'care cap' have focused on its likely dire impact on the residential care market (England's care tragedy, page 19 and But it should not be overlooked how the care cap could have affected the whole adult social care system.

"Personalisation" - or cash for care - is based on a Faustian pact between citizen and state: "Here's £500. Go and look after granny." Very few questions asked.

In 2009 I attended one of the first DH conferences on this Great Leap Forward. The director of finance from a south London borough was cynical: "We'll be stuck funding existing packages of care, but when new people turn up wanting help they'll know nothing about how the system works. We'll offer them some money in their hand and they'll think it's Christmas."

That, by and large, has been how it has worked ever since. Councils apply the dark arts of a resource allocation system (RAS), come up with a specious amount, and people tug their forelocks and gratefully take the cash. Far too many have fallen for the con trick that a "personal budget" was just that: a limited amount of cash that had to be budgeted to provide care and support. Far too few woke up to their legal right - extant long before the Care Act - to sufficient funding to cover the cost of meeting assessed eligible needs.

With the cap there could have been a "hang on a minute" moment in many households. Once people realised that money spent on care in the home would count towards the cap, they would have started counting the true cost. Councils would have been required to produce notional costing for each element of community care and people would have been arguing over every extra pound spent. Peak transaction costs for all, but also highlighting the gaping hole at the centre of a policy aimed at replacing adult social care with a means-tested welfare benefits system.

It's unlikely that consideration was a main driver in abandoning the 2016 implementation, but is the genie out of the bottle? Will 'self funders' in residential care stop paying the cross-subsidy? Will recipients of care in the community no longer take whatever sum they're offered?

I should love to believe that the public will wake up to their full rights under community care law. Perhaps this kickback might just kick-start a rebellion in the ranks.

Peter Palladas

It's the economy that comes first

There is a real danger of putting the cart before the horse in the debate about localisation (Cities could provide £9bn boost to Treasury, 6 July, bit. …

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