Good news, bad news

Margaret WheelerMargaret Wheeler on the two faces of the government’s new Care Bill

One in four babies born today will live to 100. That is a striking statistic, and an impressive testimony to advances in medicine. But also a demographic challenge which will put ever increasing pressure on our care system.

Those amongst us who will be affected by the need to depend on care in our older age, or as younger adults, through disability, must currently enter into the vagaries of a cruel lottery. Will we be the ones to fall ill, and at what age? Will our partner become afflicted with multiple long-term and debilitating conditions requiring expensive and extensive support?  Or will be live long and healthily and independent?  The uncertainty can cause distress, financial hardship and isolation.

We need a fairer, simpler and more sustainable system of social care, and it is clear that we need action to be taken now.

To this extent, the Care Bill is a welcome step forward. It streamlines and consolidates social care law, bringing effect to the excellent report of the Law Commission set up by Labour in 2009 to complete this long-overdue task. It refocuses support to more patient-centred services, better suited to people’s lives and needs, improving access to information and advice, strengthening the legal rights of carers, standardising eligibility criteria, and establishing well-being as the guiding principle.

We strongly support all of this, as it takes forward our work on patient choice and control, and builds on the progress we made on prevention, personalisation, and carer recognition in our landmark National Carers Strategy.

Sadly, that’s where the good news ends.

Coalition Ministers will claim the Bill – in implementing the government’s interpretation of Dilnot – has laid to rest the uncertainty of the adult social care lottery. There is a real risk however, that the benefits of these proposals are being mis-sold.

The cap – £72,000 for an individual, £140,000 for a couple – will not be enough to stop people with modest properties, especially in the north of England, having to sell their homes to pay for care. The squeezed middle – those who have worked hard, proudly invested in a home, and tried to save for their older age – risk missing out.  

People will still only get free care if they have income or assets under the lower means-tested limit, which isn’t being increased and will be £17,500 in 2017. Those with income or assets between £17,500 and £123,000 will get a sliding scale of support from councils, as they do now. The cap won’t limit the costs that elderly people actually pay for their residential care, and the issue of differing local authority care charges which will only accentuate the problems likely to face self-funders in the new system, must be address with urgency now.

Under the deferred payment scheme, councils will loan people money to cover their care costs; something that now has to be paid back with interest, most likely by selling the family home after the elderly person has died.  And many in care homes will sadly die before the cap introduced by this Bill and set at this level is reached.

The measures contained in this Bill risk at best being a partial solution to the deep problems afflicting our care system – unless the new legal framework is introduced in the context of addressing current and future social care funding needs. Given the scale of the Coalition’s cuts to local authority budgets, the measures put forward risk raising expectations that can’t possibly be met.

Labour will take scrutiny of this Bill particularly seriously, but we are also calling on Ministers to think again about the context in which they are proposing these changes. Strains and stresses on councils, resources cut to the bones, a health and social care system fragmented by the recent Health and Social Care Act will all conspire against reforms that could have actually been positive steps forward.

Baroness Margaret Wheeler is a member of the Shadow Health team in the Lords

Published 21st May 2013

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