What the cap on care costs doesn't do

Elderly hand holding coins Ministers want to cap the costs of social care, but there are some caveats

Ministers are hailing their changes to social care as the solution to the long-standing problem of how to care for the elderly.

The introduction of a £75,000 cap - if introduced - will arguably be the first time the system has been overhauled since it was created along with the NHS after the Second World War.

Understandably, the plans have been widely welcomed with campaigners willing to give the government credit for doing this at a time when the financial situation makes it harder to do than it has been for a long-time.

But despite the breakthrough it is not quite the panacea it may seem on first glance.

Many people will still not get any help from the state

The government is effectively saying it wants to see a partnership between the state and individual.

It is promising to pick up the really high costs, while leaving the individual to cover the cost of the average care package.

But less than a fifth of people face costs in excess of £75,000, meaning the majority of people will still have to pay all of their bill.

About a quarter of people do not develop any care needs - or very little, while for another quarter the costs of care are below £20,000.

However, for a third of people the bill is between £20,000 and £75,000 - they will not get any help unless they fall below the means-testing threshold as the least well-off do not have to pay the full costs of care.

But of course many will say that is better than the current situation where people can face unlimited costs - and the hope is that the insurance industry will develop products that will cover the costs people face.

You won't be able to shop around for the best services

The cap only includes services that are available at the normal council cost.

If you want to move into a luxury care home or pay to get the best help you will have to cover that extra cost yourself.

Any spending above what the local council would have paid for would not count towards the cap, leaving the individual to top up their package.

It means relying on the current quality of services available if you want to stay within that £75,000 sum.

Unfortunately the system, according to the Local Government Association, is drastically under-funded, which is hampering the ability to meet the needs of the elderly.

The government spends less than £10bn a year on social care for the elderly - a tenth of what is spent on the NHS and a quarter of the defence budget.

The criteria for being entitled to social care help will be extremely high

Just because you develop a care need, it does not mean you will fall within the system.

Only those with needs classed as severe or substantial will be entitled to help - that basically means you need round-the-clock help.

Any spending before you reach that level of need will not count towards the £75,000 cap.

It will mean many will still have to struggle to get by on their own until their situation worsens.

That is no different to how it is now, although a decade ago many councils were able to offer help to those with low or moderate needs.

The social care system, in a nutshell, will only be there for the most frail.

Care homes will still be expensive places

A cap of £75,000 is a substantial sum of money, but on top of that people face paying so-called accommodation costs.

This is to cover the cost of things such as food, bills and renting the room.

Of course, these are the kind of costs elderly people face if they are in their own home - and that is one of the reasons why there is a state pension.

But with annual "accommodation" bills often hitting the £10,000 mark, a care home place will be a more expensive arrangement than the status quo for most.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this

    Comment number 229.

    If anyone is thinking of giving their assets away (or even going on a nice holiday, helping their grandchilderen with housing costs etc.) they should look at the rules on voluntary deprivation, in effect certain expenditure will be added to the cap.

  • rate this

    Comment number 228.

    NHS used to pay the full cost of medical care for those in Care Homes but did not cover board and lodgings or non-medical personal care . The £75,000 (?) cap only covers medical care, so is this actually a cost which previously had to be paid by the NHS?

  • rate this

    Comment number 227.

    Tell them you are struggling and a rota of 1 hour each is needed to look after this pt. If the qualified ignores this plea on 2 occasions I would go home sick. I would hope it doesn't each that conclusion but i have seen it that no one whether the Queen Mother or a Qualified Nurse wants to special the agitated demented guy.
    It's not fair on the pt. nor the staff and it's not worth abusing another

  • rate this

    Comment number 226.

    It is never ok to shout or man handle ppl.
    I would wager that that HCA was left to cope while her co workers were 'i'm all right jack'. I've seen ppl expected to stay 11.5 hours with pts like this. My advice would be to approach the qualified nurse, who's patient it is, it's not the HCAs patient.

  • rate this

    Comment number 225.

    For what it is worth my Wife works, including travelling time, 0800 - 1800. Mon to Fri. I work 2 nights a week 1900 - 0730 and i then work Saturday 12.00 - 19.00 and Sunday 0930 - 1615.
    I could work less but we are currently saving for a 1/3 deposit for a home of our own. I am no brain box but I guess I could do something more taxing than the work that I do but I need the hours.

  • rate this

    Comment number 224.

    #222 -.NoBritwantstolookaftertheold - agree with your comment about 'support', but how can anyone devote sufficient time to their loved ones if they have the usual domestic bills that somehow still need to be paid?

  • rate this

    Comment number 223.

    IMHO, the welfare state does not encourage people to take care of themselves. Our politicians are available for a dime a dozen - they no longer have integrity, think in sound bites, the policies they dream up reflect theis. I know that labour under Tony & Gordon lost the plot completely, believing they were doing good - most megalomaniacs have no idea of the harm they cause!

  • rate this

    Comment number 222.

    Elderly ppl, and more so those with failing memory need their family. I've seen strangers try and feed them unsuccessfully and then a relative comes in and they accept the food, etc.
    To sit with someone experiencing dementia or delirium when they are agitated is no joke but I imagine they sat up for you when you had chicken pox etc.
    The State should support not do it all for you.

  • rate this

    Comment number 221.

    Politicians as a whole never look back at things they have done & recognize it is they who are causing problems not solving them.
    They setup universal health care with good intentions, unfortunately they are as a group not the type to consider cause and effect and they listened to the foxes when the designing the chicken coop so the blossoming of "preventive care".

  • rate this

    Comment number 220.

    #218 Nobritwantstolookaftertheold
    I think your name says it all - we want others to look after our elderly, but we are not willing to pay the price. Both our children & the elderly in care homes, where abuse takes place unchallenged is because we are not prepared to take the job on ourselves. The health service is only manageable because of the low wages we pay those actually doing the care.

  • rate this

    Comment number 219.

    217 - since the 70's at least health care costs paid by insurance in the US have included prescription medication and doctor visits - guessing NHS has been the same. Result -on US new today- baby boomers are not as healthy as their depression parents were at the same age.

  • rate this

    Comment number 218.

    Our Hospitals are stuffed with older ppl who should really be in social care or looked after by their 'loved ones'.
    These Consultants, ward Doctors, Nurses etc. etc. getting paid for baby sitting. Hospitals are not nursing homes.
    Scotland ain't going to afford it for much longer, wait and see.

  • rate this

    Comment number 217.

    You understand that NI is for if you happen to get squashed by a car an ambulance will turn up. If you never use it then congratz but it ain't all saved up for you so your lazy family don't have to bother looking after you.
    Cost of care, if 1960s you got an aspirin and your arm in a sling. Now you can survive far more and have better quality. This costs far more than the 2 bob u put in.

  • rate this

    Comment number 216.

    Wish we were given the opportunity to have our say on England being independent we pay for everything and get nothing , still paying for prescriptions as well !!

  • rate this

    Comment number 215.

    Why am I paying for the Scots to get it free ? Role on independance.

  • rate this

    Comment number 214.

    Perhaps we should stop taking drugs to keep us living for longer, although the quality of our life may not be what we expected? The medical profession with their fantastic expensive technology to keep people living for longer, should have a re-think about their ideology, at one time medics tried not to cause harm, this is no longer the case as many of their treatments do and can cause harm.

  • rate this

    Comment number 213.

    How many people would select a council care home for their mum and dad if they had visited some private ones first!?
    Like private schools,I wonder what % of MPs,Ministers, parents are in council care homes?
    In life, what people do is a much more reliable barometer of what they really think and feel, than what they say I've found
    Most people can guess the headlines that await us ALL in the future!

  • rate this

    Comment number 212.

    Another con by the nasty two. Only those with needs classed as severe or substantial will be entitled to help - that basically means you need round-the-clock help.

    Any spending before you reach that level of need will not count towards the £75,000 cap.
    Smoke and mirrors, but rejoice it won't effect the rich will it. All in it together pah

  • rate this

    Comment number 211.

    40 spiceboy
    Totally agree,but!
    Is there not a correlation between the cost of care and the monthly bill that the vast majority already cant afford to pay?
    Looks like a Mexican stand off,we ALL want decent care but cant spend what we hav'nt got,and with our relatives forced to move to remain employed, or even if local they are all having to work for many more years,what is the option?

  • rate this

    Comment number 210.

    And always that the private sector is best. Insurers will hopefully provide a product, without cherrypicking the healthy ones... How could anyone think such a thing... Intergrate the hospitals and elderly care systems, and what would it cost on income tax to provide free care for all when you're in a home, Mr Hunt?


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