Magazine article Public Finance

Calling Time on Care Funding

Magazine article Public Finance

Calling Time on Care Funding

Article excerpt

Social care wasn't just the dog that barked in June's general election. It went on the щ rampage, tore up the furniture and nearly mauled its owner to death.

The bright sparks who thought it a good idea to alienate vast swathes of middle England by inserting a so-called "dementia tax" into the Conservative manifesto have long since been shown the door.

But the mess they left behind - particularly after Theresa May's U-turn on the subject - not only helped lose the government its majority. It also landed her fragile administration with a huge dilemma: how to solve a problem like social care funding without earning the opprobrium of older voters and their offspring.

The ill-fated manifesto proposals, which ditched a future cap on care costs and created new liabilities for home care charges, were greeted with even more uproar than Labour's 2010 "death tax".

So can politicians ever say anything meaningful about care charges, winter fuel allowances or triple-lock pension entitlements without instantly undermining the all-important grey vote?

Previous governments have generally opted to play dead on the issue. Or to set up a commission and ignore its findings, which amounts to the same thing. Given the choice - particularly after the June debacle - this administration would like to follow suit.

Recently appointed care minister Jackie Doyle-Price has been keeping an even lower profile than her predecessor David Mowat. Both the Department of Health and the Cabinet Office, which is leading the consultation process, have maintained near radio silence on the long-promised social care funding green paper. The topic was off limits at the Conservative party conference.

Although there is some expectation of an announcement in the chancellor's autumn Budget, local government insiders say the issue has been downgraded by Whitehall. Ministers are far more preoccupied with intergenerational fairness and courting the elusive youth vote.

Even so, forgetting about the care costs conundrum is not an option, not least because of its impact on the NHS.

Ironically, the manifesto meltdown has had an upside. "The good news is there is growing public recognition of the issues," says Izzi Seccombe, chair of the Local Government Association's community wellbeing board. "The election debate showed that, and the vast majority of MPs agree there needs to be a cross-party solution. This momentum must be maintained."

Numerous commission and inquiry reports have spelt out just how inequitable and unsustainable existing funding arrangements are.

Sir Andrew Dilnot - and before him Lord Sutherland, Sir Derek Wanless and Dame Kate Barker - have all made the case for a new social care funding settlement (see panel overleaf).

The problems they identified - rising demographic pressures on services, particularly for the over-80s, soaring levels of unmet need and unjustifiable postcode lotteries of care - are intensifying by the decade.

Above all, there is the division between health and social care funding. This determines, for example, that an older person with cancer will be provided for by the state whereas the one with Alzheimer's will not.

It was this recognition of the potentially "catastrophic costs" of long-term social care that prompted the Dilnot Commission, in 2011, to propose a cap of ?35,000 on lifetime (non-hotel) care costs.

And it was the cap's proposed replacement with an asset floor of ?100,000, collectable after death, that caused such outrage and the use of the term "dementia tax". In the election debate, Dilnot said the manifesto proposal would have left people "helpless" and "completely on their own", unable to pool their risks to plan for future care costs.

On paper - or at least until the green paper consultation - the government is still committed, under the Care Act 2014, to introduce a "Dilnot-lite" care costs cap of ?72,000 in 2020, along with a raised means test floor for publicly funded care. …

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