Selasa, 10 Juli 2012

Anger over social-care confusion

Elderly manMinisters are looking to reform social care

Anger is mounting over the government's plans to reform social care in England, which are due to be set out in its Care and Support White Paper later.

The government has said it agrees in principle with the idea of capping how much people have to pay but it will not explain how or when this will happen.

Instead it will focus on promising more equal access to council care.

But charities and council leaders are warning greater clarity is needed on funding the overstretched system.

'Loan scheme'

At the moment, each council can set its own eligibility criteria for care for the elderly and disabled.

Ministers will promise national standards by 2015 setting out who is entitled to help at home and residential care places.

There will also be a specific promise to allow those who face the largest costs 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 - anyone with assets of more than £23,250 does not get help - will have their fees paid for and then recovered from their estate.

What to look out for

The government has already released a lot of details about what will be in its Care and Support White Paper. But as always the devil will be in the details.

  • Funding - The issue of capping costs has been relegated to a progress report, meaning there will be no firm commitments. But how it is worded and any detail about a timetable for making a decision will be key.
  • Social care at the end of life - Free care was ruled out long ago, but there have been suggestions free help at the end of life could be piloted. While expensive, it could be funded from savings to the NHS as people often end up in hospital during their final days.
  • National standards - The white paper will include details of a national system of eligibility. This will cover how severe a person's needs are for them to be considered for help. The key will be at what threshold this is set at. The higher it is set, the smaller the number of people who get help.

But despite cross-party talks on the issue of funding and an independent review last year recommending a cap of £35,000 being placed on costs, ministers will not make specific commitments on what many believe is the key issue to reforming a system that is commonly said to be in crisis.

The cap is viewed as an essential way of getting the public to plan for old age and to encourage the insurance industry to get involved in developing policies for them, as it protects both from the risk of unlimited care costs.

Without this engagement, social care is deemed as unsustainable as free social care has already been ruled out.

'Urgent timetable'

The cap will be mentioned in a separate "progress report" accompanying the white paper, but it will not put forward any favoured proposals, government sources told the BBC.

Ministers have argued it is still possible legislation to reform funding will be introduced in this parliament, but many in the sector have expressed disappointment at the delay and are now arguing there needs to more detail about how the government will proceed from here.

Sir Merrick Cockell, chairman of the Local Government Association, said: "There is an immediate crisis in social care which needs to be urgently addressed now.

Elderly person with walking stick

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

"No-one would disagree that care should focus on an individual's needs, but attempts to improve the quality of care are meaningless if there is no money for councils to provide these services."

Michelle Mitchell, of Age UK, said: "The proposals will not live up to ambition without the solid foundation of a fair and sustainable funding structure so we need the government to make it clear how reforms will be funded and set out a clear timetable."

And Carers UK chief executive Helena Herklots added: "Delay is not an option... families will demand an urgent timetable."

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