Social care cap delayed as cheaper option sought

David Allen, multiple sclerosis sufferer: "I do feel abandoned. And I do, at times, feel bullied."

Ministers have refused to fully commit to a cap on care costs which the elderly and disabled must pay in England, saying they need to explore cheaper options first.

A review last year proposed capping lifetime costs at £35,000 - but ministers said the current climate meant it had to look at other options.

Other funding ideas include a higher cap or a fee to opt in to the system.

The move has disappointed those involved in the social care system.

The announcement on funding - unveiled alongside a white paper and draft bill which sets out other changes to social care - has long been anticipated.

On taking power, the coalition had said it would look at funding amid concerns from councils and the elderly and disabled who rely on the services that the system was struggling to cope.

It asked an economist, Andrew Dilnot, to come up with recommendations and he reported back last summer recommending the £35,000 cap.

National standards

But after a year of talks with a variety of people inside and outside government, Health Secretary Andrew Lansley said while it was the "right basis" for change he could not yet fully commit to it.

Who gets what care

social care promo image

He said a final decision would be taken by the next spending review, which could be two years away.

Among the options the government said it was looking at was raising the level of the cap - £75,000 has been suggested - or asking people to opt in by paying an upfront fee. Those that did not pay the fee would face unlimited costs.

Also under consideration is whether reductions in spending on other areas, such as universal benefits targeted at the elderly including winter fuel payments, free TV licences and travel concessions, could be used to fund a cap.

The Dilnot review said a cap of £35,000 would cost £1.7bn a year to start with.

He also recommended the wealth threshold at which people no longer get state help - anyone with assets of more than £23,250 has to foot the bill - should be increased to £100,000 for those needing residential care. Again the government said it would need to consider this.

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Jeremy Hughes, of the Alzheimer's Society, said: "Millions of people had been promised radical reforms, but today they are being massively let down."

Sir Stephen Bubb, chief executive of the Association of Chief Executives of Voluntary Organisations, added the Treasury was "strangling reform" as the Dilnot review was a "ready solution".

"What they don't realise is the huge cost to the health service which is mounting by refusing to take action on social care."

But despite the delay on funding, Mr Lansley was able to announce a series of other changes to the system.

From 2015 there will be a national standards setting out who is entitled to help at home and residential care places.

At the moment, each of the 152 councils in England can set its own eligibility criteria for care for the elderly and disabled.

'Comprehensive overhaul'

Those who face the largest costs will also be able to defer payment until after their death.

Key points

  • Funding - Capping costs is considered the "right basis" for change, but there is no commitment to introduce it. Instead, ministers want to look at cheaper options to the £35,000 level suggested last year.
  • Deferred loan scheme - This will be made available to those who need to pay for residential care. It means the costs they incur can be taken from their estate after death. Interest will be charged.
  • National standards on access - A universal threshold will be set detailing who can get access to care. At the moment each council can set its own criteria. But the risk is that those councils that are more generous now will end up tightening their criteria under the change.
  • Moving home - Those receiving care will get the right to transfer their packages to other parts of the country if they move. Currently they have to undergo new assessments, which results in some losing out.

This loan scheme, which is already available in some areas, means those who need to go into care homes and are not entitled to state funding will have their fees paid for and then recovered from their estate.

Interest would accumulate on the loan.

Mr Lansley said despite the need to look at the cap in more detail, the other changes would benefit those in need.

"Our plans will bring the most comprehensive overhaul of social care since 1948 and will mean that people get the care and support that they need to be safe and to live well so they don't reach a crisis point."

Shadow health secretary Andy Burnham said: "With no answers on the money, this white paper fails the credibility test - it is half a plan.

"The proposals set out today are in danger of appearing meaningless and may in fact raise false hopes among older people, their carers and families."

While the changes announced apply only to England, the recommendations will be carefully looked at by the other parts of the UK as they are also reviewing their social care systems.

Wales and Northern Ireland have similar means-tested systems as England, but in Scotland personal care is provided free although this system is coming under increasing pressure.

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