GrumbleSmiles

This blog follows on from “Social Care White Paper 1”.  (Click on Dilnot Commission in the TAG CLOUD to see earlier posts).

It continues the discussion on the social care white paper and the future funding long-term care of older people.

Whilst the continued prevarication is disappointing, there are some promising signs in the white paper that the Government is gradually beginning to chart a way forward.  But — you have to read between the lines — here is my attempt at understanding what the Secretary of State is hinting at  :-

• Andrew Lansley agrees with the principles of the Dilnot report.
• • This means it is quite a long way from political acceptability and we will not act on its recommendations until we can be convinced they are election-winning proposals, —- i.e. after the next general election.
• A cap on care costs is accepted but the level set at £35,000 or even £50,000 may be too low.
  • The £100,000 being considered by the Department of Health is just a softener for a cap of around £60,000.   This covers the cost if about two years’ stay in residential care (including £10,000 annual accommodation costs).   It will provide for the remaining lifespan of most residents — except those with mild dementia or long-term disability.
• The Government is setting up standard eligibility criteria for access to residential care.
  • This is thinly disguised code for limiting residential care to critical and substantial care.   In practice this has already happened, but it needs to be legitimized before an insurance scheme can be introduced.
• The Government is setting up a loan scheme to allow people to keep their homes if they move into residential care.
  • This is a sop to the chorus of media outcry about people having to sell their homes to pay for care and it may avoid the “death tax” lable.  In practice why do people need to keep a home if they move permanently into residential care.
  • The good news is that it  is also opening the door which leads  older people to use equity release to pay for care, which is the only realistic long-term solution.
• The Government are considering a voluntary scheme of insurance for long-term care.
  •  This is recognition that the commercial insurance industry are not likely to take this issue up quickly.   Equally the Government, by floating the idea of an opt-out or opt-in scheme, are testing the water, in terms of acceptability.    Personally, I doubt if people will opt in unless the premium is very low (less than £10,000).   However, this has to be the right way forward and it ultimately prepares the way for a universal social care insurance scheme which ensures that everybody – young and old – insure for their frail future.

So overall, whilst the continuing prevarication is disappointing, it is probably a necessary adjustment period.   The more important thing is that at least the signs are pointing in the right direction.

I have already written  about the Dilnot Commission and their proposals for the future funding of social care.  (click on  Dilnot Commission  in the TAG CLOUD)

There is no question that social care in this country is in a crisis; report after report over the last two years points to that.   Equally, the weight of older people arriving at hospitals has dragged NHS care of the elderly well below acceptable levels.

That is why the publication of the social care white paper was so eagerly awaited and so quick to disappoint.   The Government had already announced in advance that there was to be no decision on the Dilnot report, but many people were still hoping against hope, that some decision would be forthcoming.   Predictably when the paper was finally released, there was universal condemnation of the continued delay.

However, I take a different view and understand the politicians prevaracation.   The voluntary sector has proved itself not ready for the required solution, by continuing to demand more Government money.   Encouraged by the voluntary sector position the media continues to beat the drum about older people having to sell their homes to pay for care.

Before we can move on with this debate, we have to explore the myth believed by many elderly people about the difference in virtue between renters and owners.  Renters are not feckless individuals who wasted their money on beer, cigarettes, Sky TV and holidays in Spain.  Nor are they all life-long unemployed people or work shy wasters with fake disabilities living on the state.   Neither on the other side of the divide are owner occupiers people who sweated all their working lives to pay their mortgages to buy their Englishman’s Castle.   Yes they did have to work hard and save the pennies as well as the pounds, but the largest part of homeowners’ wealth was accumulated as they were sleeping.  House price inflation was a direct result of over easy credit, when as a society we should have been saving for our frail futures.

Unfortunately, there are extreme examples of selfishness and greed that allow the headline hungry media to continue to promote the differences.   A few people earning £100,000 a year still living in a Council house and on the other side of the fence, wealthy homeowners still claiming their winter fuel allowance.  The reality as the pensioner years approach, is that frailty is a great leveler.  Your health becomes much more important than whether you own your home.

It is this ill-informed and wrong-headed stance that is blocking progress on the Dilnot report and the Government is right to consider it as “work in progress”.  Dilnot was never the whole answer, because none of the political parties nor the electorate would vote for the harsh reality of some of the necessary changes.

There simply is not enough money for free social care for all, given the increase in longevity and the growth in the older elderly population.  It is a collective failure.  Both successive Governments and individuals have not set aside enough money for a future frail retirement.

Except the picture is not quite so bleak – not everyone will become frail.  The problem is we don’t know who will be affected.  That is why insurance for long-term care is critical to the solution and both Andrew Lansley and Andrew Dilnot recognise that.  The other good news is that we have saved by default through more older people becoming homeowners.

So for now the status quo is sadly the only place to be until an adjustment to the stalemate becomes politically electable.  Let’s hope it is by the next general election.

Politicians reflect our thinking!