Social care plans 'simply paper over cracks'

By Nick Triggle
Health correspondent, BBC News

media captionDavid Allen, Multiple sclerosis sufferer: "I do feel abandoned. And I do, at times, feel bullied"

The elderly and disabled face years of misery because the government has failed in its overhaul of social care, council leaders and campaigners say.

The Local Government Association accused ministers of "papering over the cracks" after they refused to commit to capping the lifetime costs people face.

Last year an official review recommended a limit of £35,000.

But the government said while a cap was the "right basis" for change, it needed more time to look for cheaper options.

The announcement on funding - unveiled alongside a white paper and draft bill which set 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 the economist Andrew Dilnot to come up with recommendations and he reported back last summer recommending the £35,000 cap.

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.

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.

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 currently 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.

While some parts of the proposals were welcomed by the social care sector, many organisations rounded on the government for failing to go further.

Sir Merrick Cockell, chairman of the Local Government Association, said the plans did not go "far enough" and "simply paper over the cracks".

"Council leaders are disappointed that the white paper does not address the reality of the current and growing funding crisis."

"We are concerned that under the proposed timetable, elderly and disabled people, as well as carers, could face at least a further five years of uncertainty."

media captionHealth Secretary Andrew Lansley: "We should contract for quality and service not by the clock"

Richard Humphries, of the King's Fund think-tank, said "the government has failed to produce a clear plan".

"There is a financial vacuum at the heart of these proposals."

And Michelle Mitchell, of Age UK, said: "Sadly, the delay on a funding decision will undoubtedly have a devastating impact on those currently in need of care support today."

She added the lack of clarity also raised the question about whether a cap would ever be introduced at all.

But Mr Dilnot said he still held out hope his ideas would be introduced, pointing out that they would cost just one one-thousandth of public spending.

"At that level it is a price worth paying," he added.

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.

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 careers 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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