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Government to re-visit perennial problem of care costs for the elderly?

Norman Lamb, the Coalition Health Minister, has called for the issue of how to fund care for the elderly to be addressed urgently by the Government. In an interview with the Daily Mail this week, Lamb said that legislation must be brought in to address the principal of capping care costs.

The cap was a key recommendation of the Government-appointed Dilnot Commission, charged with making recommendations on how long-term care for the elderly should be funded in the future. The report, published in July this year, advised that the cap, after which the state would fund care, should be set at between £25,000 and £50,000, with £35,000 as the most reasonable figure.

Currently, an unsatisfactory state of affairs exists, where many elderly people deplete their life-savings or sell their homes to fund a move into a residential care home or nursing home; the latter providing on-site medical services. Care home services usually cost at least £26,000 per year.

Some elderly people can have their residential care fully funded by their local Primary Care Trust, but local criteria will usually limit this to those with substantial medical or social need. For the rest of the UK’s senior population, social care is means-tested by Local Authority Social Services departments and governed by the National Assistance Act (Assessment of Resources) Regulations 1992.

In the Spending Review undertaken in 2010, the Government set capital limits for residential care charges, provisionally until 2015; but there is no upper limit for expenditure on care by an elderly individual.

Thus, under the current Charging for Residential Care Regulations Guides (CRAG) for England, Wales and Northern Ireland, those who want to receive care while remaining in their own homes must pay the full cost if they have savings of more than £23,250. Those who choose residential care must also pay the full cost if they have total assets of more than £23,250, including income, savings, investments and property.

Although a mid-term review of the social care system will be published by ministers within a few days, Lamb does not expect the Government to spell out the level at which any cap on care costs paid by the elderly would be set.

The Minister appears frustrated by this. He told the Mail: “Dilnot must happen. We have just got to get on with it. We have got to announce it is going to happen, set the cap and legislate for it in the Care and Support Bill in the next session.”

Recently, the Care Minister’s predecessor, Paul Burstow, has re-entered the debate by calling for the majority of pensioners to lose their entitlement to winter fuel allowance, in order to fund necessary reforms to the care system, including a cap on residential costs for the elderly. However, he recommended that the cap should be set at £60,000, rather than the Dilnot-recommended £35,000.

According to the Mail, Burstow calculates that if only the poorest members of this section of society get the £200 fuel allowance for pensioner households, or £300 for those over 80, then the country could save £1.5 billion a year.

Burstow argues: “Placing a cap on the amount people have to pay for care would protect people from the catastrophic costs they face now. But to make this vital and long overdue change, we have to find the money from somewhere.”

Nonetheless, David Cameron made a pre-election pledge to protect benefits for the elderly, such as the winter fuel allowance, the free bus passes and free TV licences; therefore he is unlikely to support Burstow’s radical idea.

It might be argued that a cap, at whichever level it is set, would actually make little difference to most pensioners who enter residential care, as life expectancy is often quite low for this category of elderly person; therefore, they would be unlikely to exceed the limit of the cap. On the other hand, for someone with a progressive disease like dementia, where the need for care could be greater and last longer, a cap may prove financially beneficial.

Notably, if the threshold for state help is not raised significantly, then it would appear many of the less well-off elderly will not be saved from having to sell their homes to meet care costs. The Dilnot report recommended that the means-tested threshold should be increased from £23,250 to £100,000

Lamb also advocates greater community support to prevent residential care being used unnecessarily; an initiative that he believes should be promoted by local councils. According to the BBC, the Minister says: “With the right support and the right community resilience and a rebuilding of the neighbour support that used to be there, more people could stay in their own homes for longer.”

While a considerate and supportive society is an ideal for many, and would probably make the Government’s job far easier, the fact remains that care for the elderly is in crisis, and the steep costs can affect pensioners’ quality of life, as well as the future security they may wish for their families.

The Government must grasp the nettle and work out an equitable method for funding greater state assistance, and bringing in legislation for a cap on the amount the elderly have to spend for care would be a positive first step; but the means-tested threshold should also be raised.

Otherwise, as our population ages, we may face the prospect of advanced years and associated infirmity being the second most expensive item we will ever purchase, after a home; with care costs successively leeching hard-earned wealth away from families.

Original story:

The Daily Mail

BBC

One comment on “Government to re-visit perennial problem of care costs for the elderly?

  1. As a pensioner living abroad, wish to express my condemnation of the victimization that continues today, for pensioners that choose to live abroad, although they remove themselves from care of the state, are refused any increase or extra benefits available to pensioners who remain home, why is this allowed to betray the old, who is the most costly ?.

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