Implementing a model for funding social care

12 March 2013

Reform’s conference, Implementing a funding model for social care, showed how much further there is still to go in bringing about a solution for funding long term care. While the Government’s announcement of a broad architecture based on the recommendations of the Dilnot Commission is to be welcomed, it is only the beginning. Challenges remain around the technical design of the new system, the role of local authorities and the role of financial services. Significant hurdles also remain around awareness, information and advice. Most crucially, this area of policy opens up a far wider conversation about necessary NHS reform and the responsibility of the individual and the State.

Speaking at the conference, Lord Warner set out the technical design challenges which remain and which should be addressed by the Care and Support Bill. These include the new assessment system and the need for it to be transferable if people move; the eligibility criteria for entitlement and National Minimum Eligibility; and how charging will work, particularly the metering system to work out how costs contribute to the cap. All of these issues highlight that we are just at the beginning of implementing a solution.

As Heather Wheeler MP also pointed out at the conference, local government often funds, commissions and, in some cases, provides care. There is a fundamental role for Local Authorities in making the new system work. One particular challenge raised at the conference was how the role of Local Authorities could be increased in the face of tighter budgets. There is going to be a greater need to do more with less and innovative practices should be shared and spread. Evidence also shows that there is scope for increasing value for money through earlier interventions and preventive provision.

Both the initial Dilnot Report and the Government’s plans envisage a greater role for financial services and there are clearly some benefits to be realised from products such as equity release. There is currently £750 billion of equity tied up in housing in the UK. Yet the conference also raised challenges in this area too: Are there still problems of trust and confidence in the financial services sector? How could the debate on auto-enrolment lead to a broader discussion around building financial resilience?

Increased take up of financial services products will rely on better informed consumers and the Care and Support Bill will make it a statutory requirement for trustworthy and impartial information to be provided to those people needing care. This advice challenge is part of a wider need to improve understanding of the system overall. Awareness is still at startlingly low levels, with many families only becoming aware of the system and the costs can people incur at the point of need. Although the new system will be an improvement on the current model, there are important complexities that will need to be recognised, including what will count towards the cap on costs.

The biggest can of worms opened at the conference was the politics of change. As well as the challenges surrounding the 2015 election and an increasingly large “grey vote”, making decisions on who is responsible for funding care opens up a wider debate about the boundary between the individual and the State across policy areas, particularly the NHS. Not only does there need to be better integration between NHS and social care services, but the structure of the NHS needs to change to better deliver services.

Reform of long term care funding has been discussed for more than a decade now and it will not be an easy task to implement a new system. But we can no longer afford to delay. By working together, central government, local government, the private sector, the third sector and the financial services sector can make a solution and its implementation successful. As Norman Lamb MP said in his keynote address to the conference, “we have just got to get on with it.”

Reform major policy conference on 5 March 2013, “Implementing a model for funding social care”, with Norman Lamb MP, Lord Norman Warner and Heather Wheeler MP, kindly sponsored by the CII, Gen Re, Just Retirement and Partnership.

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