Some of the early indications from the Dilnot Commission would suggest that they intend to fully embrace some of the age old problems in the funding of long term care. Certainly it will be very welcome if there is a resolution of the tension between the partly-funded social care system and the free services currently classified as NHS Continuing Care, this has been a longstanding grey area which has been interpreted in a multitude of ways by different PCT’s. It will also be good to see an unequivocal statement on free and means-tested entitlements set on a national basis so that elderly people and their relatives can have a common understanding of what they can expect from both Social Services and the NHS in terms of quality and funding support.
It is already clear that there is going to be far greater sharing of costs, but the split between the State and the individual will heavily depend on just how much extra public funding is forthcoming. As the demographic pressures increase in the years ahead I would be surprised if the State is able to fund much more than the critical/substantial means-tested cases that are currently funded.
I also strongly agree with the suggestion that today’s system must be improved before anything else. Otherwise it’s difficult to imagine why elderly people would wish to pay more for the current abismally poor standards of care.
As always the devil will be in the detail but the fundamental question of where the additional funds are to come from has yet to be faced by both Andrew Dilnot’s team and then later the politicians. I believe this can only be achieved by a radical restructuring of the provision of long term care away from the NHS and towards a higher quality of social care provision, both in the community and the residential home sector.
This follows on from my submission to the Dilnot Commission dated 6 February 2011 and my follow up blogs dated 27 February 2011 and 3 March 2011.