Change that leads to better lives

Social care ‘reform’: funding more of the same?

The news feeds and social media have been alive today with the announcement on social care funding that was trailed over the weekend. The coalition government has unveiled plans to set a cap for paying for social care at £75,000 at 2017 prices, and to increase the capital limit – the value of assets at which one starts paying for their own social care – to £123,000.

This latter change takes forward the recommendation of the Dilnot Commission that the capital limit be raised to £100,000. The government has said that this will cost £1billion a year by the end of the next parliament, and is proposing a freeze on the inheritance tax threshold to pay for it, the setting of national eligibility criteria, and a wider range of financial products.

Successive governments have thrown around the care funding hot potato for as long as I have been in the health and social care world – when I joined the Department of Health in 2000 it was all about the 1999 Royal Commission on Long Term Care which proposed free personal care – which the government then rejected. Then we had the Wanless review in 2006, followed by the Dilnot Commission in 2011.

All of this focus on funding is of course important – we are living longer than ever before, which we need to celebrate, but we are still working with a social care system based on the outdated premise that not many of us would see our 70th birthday, never mind a century. Therefore, another conversation has to be had about the actual shape of social care – rather than funding more of the same, which for the most part is just not working for older people needing support.

Andrew Dilnot talked in his Today programme interview about his hope for ‘more diversity’, and a ‘wider range of care’ in the future. This is why we need to think about ensuring that older people can choose from a wider selection of support choices, particularly when they have high support needs themselves. New research, funded by the Joseph Rowntree Foundation and carried out by Community Catalysts and NDTi, finds that there is a great deal of potential in rolling out models of support based on mutual arrangements between people, such as Circles of Support, self help and peer support networks, and mutually supportive relationships and communities. These solutions can help older people both receiving and giving support to live better lives. Commissioners need to consider these wider choices when developing services and we need to work to develop ‘fertile ground’, in order to grow and sustain these alternatives.

I agree that we need to grab the social care funding crisis and find a solution. But we also need to think hard about what it is that we are funding. As Jeremy Hunt said in his Commons statement today, ‘society is ageing’. So if that is the case, why is there no wider ageing strategy, developed with older people themselves, that takes in care, support, and the whole range of issues that affect their lives?

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