The claim
“From 2014, anyone staying in residential care for more than two years will receive free care after the second year. This will mean that the most vulnerable in our society, those with the highest needs, will be protected from very high care costs.”
Building the National Care Service, Page 5
Cathy Newman checks it out
Gordon Brown was grandiose in his claims about today’s social care white paper. The prime minister said the planned National Care Service would be the biggest overhaul of the welfare state since the birth of the NHS.
Tackling the challenge of supporting an ageing population is certainly “bold”, as the PM suggested. But he ducked the biggest challenge today – finding a way of funding such universal care for the elderly.
Instead, he made a smaller down-payment on a short-term fix: an £800m-a-year promise that anyone in a residential home for more than 2 years will receive free care. But is this pledge, and the broader aim to create a National Care Service, all it’s cracked up to be?
The background
The Government has launched a white paper today, entitled “Building a National Care Service”. It’s being promoted as a major development in the history of the welfare state, and claims that it will ultimately provide for social care to be available free at the point of delivery according to need, like the NHS.
But it won’t be happening overnight. The Department of Health’s impact assessment paper says that this will be a staged approach to introducing a comprehensive care and support system and that it’s “a long-term vision for reform”.
The analysis
Free care is promised for anyone in residential care for more than two years as an interim measure. The cost of this is estimated at £800m annually when introduced in 2014/15.
But FactCheck has established that a draft copy circulated yesterday did not contain any any details about how the 2014 pledge on free residential care would be funded.
A section in the final white paper entitled “Securing our care and support system over the next five years” was omitted, and instead a note was inserted saying: “wording to be agreed by HMT, No.10 and DH special advisors later today”. Could it be that as late as yesterday the Government had not finalised how it would pay for this key policy?
The same section also makes clear that the Attendance Allowance – a disability benefit – will be reduced to help pay for the pledge (pg 132). Questioned by Channel 4 News, the health minister, Phil Hope, said the reduction amounted to £100m.
But in a later statement, the Department of Health said Attendance Allowance gets taken away from people now when they enter residential care.
The official added: “The thinking behind this is that AA is for meeting the extra costs of disability – things like getting taxis to go and do your shopping, or having someone do your gardening for you – the things you can’t do if you are disabled. If you live in a care home, those costs are met anyway. So the state doesn’t pay twice for them.”
Add to that the fact that the promise of free care doesn’t cover accommodation charges such as food and utilities. Typically this amounts to half the total costs in a care home, so charities are concerned that the disabled in particular will lose out.
In the longer term, there are other funding pressures. As the government moves towards its long term aim of setting up a National Care Service, it wants to find £4bn of savings, from 2014 onwards – of which £1.8bn will come from other areas of the NHS. Lord Warner, a former health minister, told us people in the NHS weren’t sure where that money would come from.
And the spectre of the death tax to help pay for the National Care Service still looms large. The government said it wouldn’t impose a tax on people’s estates for the duration of the next parliament. But a death tax will be an option considered by a commission looking at how to fund the Care Service.
The verdict
Beware politicians bearing gifts for the elderly. Gordon Brown’s pledge that anyone in a residential home for more than two years would qualify for free care is superficially appealing.
But the small print reveals a catch or two. Does the reduction in the attendance allowance lead to cut in disabilities benefits? And should the PM have been quite so keen to trumpet “free care” when accommodation charges can be quite so hefty.
Clearly, so close to a general election, it’s hard to get anything like plain-speaking – let alone a political consensus – on something as controversial and challenging as care for the elderly.
