The issue of paying for care has been a ticking time bomb for years and a subject I have regularly commented about – see ‘Paying for care – a ticking time bomb‘. However, today, the UK Government has announced its long overdue reform of funding its social care system in England. It has been labelled a “watershed moment” and the “biggest shakeup in a generation”.
The overhaul will place a £86,000 cap on the lifetime contributions made by individuals, with the taxpayer funding costs on top of this. The capital limit, the point at which individuals pay for care, will increase and if you have assets between £20,000 and £100,000 you will be entitled to some support.
The announcement is not without controversy as it will be funded by a 1.25% increase in National Insurance contributions, but it is much needed news for millions of families.
What is social care?
Whether it is help with washing and dressing at home or long-term care, unlike NHS care, most social care is not free. The burden on families are enormous and the demand for help has risen.
More than half of residents in elderly care homes pay all or some of their fees and 82% of places are provided by for-profit operators, according to LaingBuisson.
Today, in England, if you have assets of less than £14,250 you pay something from your income, with councils covering most of the cost for social care. But, if you have more than £23,250 in assets you pay for all your care. In Wales, the limit is more generous at £50,000.
If you have great health needs, the NHS will pay for the care under NHS Continuing Healthcare, regardless of your financial position.
Today’s announcement is not a new one. A cap on care costs was recommended 10 years ago by Sir Andrew Dilnot, who advocated a £35,000 lifetime cap. It was subsequently put into law in 2014 under the Conservative-Liberal Democrat coalition, but delayed and then eventually abandoned under David Cameron.
What does this mean for the devolved nations?
The social care system is devolved across the four UK nations, meaning today’s announcement only affects England and the devolved governments need to develop separate plans.
In England, social care is generally not provided for free. Typically, only those with savings and assets worth less than £23,250 can get help from their council and there is no overall limit on costs.
In Wales, the capital limit is more generous being £50,000 and there is a cap on domiciliary care. In May, the Welsh Government announced that it would press ahead following the UK Government’s proposal.
Personal care, such as help with washing and dressing, is free in Scotland for those assessed by their local authority as needing it. Those in a home still have to contribute towards accommodation costs and the capital limit is £28,750.
I have specialised in NHS Continuing Healthcare for over 15 years have witnessed first-hand the impact of our current system. The decisions made by families are harrowing due to the financial uncertainty compounded at a time when loved ones health has seriously declined. It is vital that individuals receive a high quality of care when it is needed and we have a fairer way of paying for long-term care.
With the average cost of residential care being £800-£1000 per week, for the hundreds of thousands of families paying 100%, the cost is astronomical, especially when loved ones have long term-conditions. Others who run out of money have to move often very vulnerable loved ones from privately funded care homes into council-funded care, which is often highly distressing and can be detrimental on their health.
Whilst how the proposed reform is funded through tax increases is controversial, and remains to be seen, setting a clear cap on contributions towards the costs of care would lift the fear and uncertainty for many from the current system and help protect those people who would pay extremely high care charges in the future.