Cap on social care fees postponed

Cap on social care fees postponed

U-turn in care funding - cap on social care fees postponed

Care fees history repeats – and self-funders bear the brunt…

When Labour’s Tony Blair reassured everyone in 1997 that no one should have to sell their home to pay for care, many people took heart. However, in the years that followed the betrayal in those words soon became apparent.

Now, in 2015, we have David Cameron’s Conservative betrayal in postponing the implementation of Phase 2 of the social care funding reforms – as set out in the Care Act. These are the reforms he campaigned on in the recent UK general election.

The stated unaffordability of the reforms are one thing. Having the courage – and frankly the decency – to abide by election promises or not to make them in the first place seem to be quite another, whatever the political party. So often, the people who bear the brunt are the most vulnerable.

Cap on social care fees postponed

Phase 2 of The Care Act made provision for a cap on social care fees of £72,000 and for a new upper means test threshold. Both of these measures were due to come into effect from April 2016. Both have now been postponed until at least 2020. Read more about the cap and the means test thresholds in this article.

(Note: these changes do not affect NHS Continuing Healthcare funding.)

Care home placements

Also postponed is the duty placed on local authorities to arrange care home placements for people who are self-funding. This is very disappointing, as local authorities are able to negotiate lower care fees for residents than a family can do. It means self-funders will continue to pay the highest fees and continue to subsidise local authorities.

Proper appeals process

Also postponed is the introduction of an appeals process within adult social care.

Deferred Payment Arrangements

The new Deferred Payment Arrangements (DPAs) remain in place. This is where the cost of care is offset against the value of a property, and those costs are subsequently recouped by the local authority at a later date. However, these new DPAs attract interest payments, whereas previously they didn’t. Since April this year people have been signing these new arrangements on the basis that care fees would be capped – and not only are they now paying interest but there is also now no guarantee of any such cap in fees.

Smoke and mirrors in health and social care funding

With all the conditions attached to the care fees ‘cap’, it was in practice going to benefit very few people. The new date of April 2020 for implementation adds insult to injury: 2020 is simply the point at which a person starts counting towards the cap; the intervening years between now and then don’t count at all. It means that many elderly people going into care now might as well forget a cap was ever even mentioned. In fact, we might as well forget there was going to be any meaningful financial reform at all in social care.

Despite the financial constraints within local authorities and the cost of implementing these social care reforms, what many people find particularly galling, is that the government must have known they were going to go back on their promises. Even so, they allowed these cash-strapped local authorities to continue to use precious budgets on training and preparing for Phase 2. When you also add in the historical cost of all the research into care funding reform previously carried out by the Dilnot Commission  back in 2011, one could be forgiven for concluding that the Care Act has so far been a colossal and obscene waste of money.

The Guardian reports that this latest u-turn has cost taxpayers up to £100m and that there are some serious questions for the government to answer.

In his letter to the chair of the Local Government Association dated 17/07/15,  Alistair Burt MP, Minister for Community and Social Care, explained that the decision to postpone Phase 2 of the Care Act had not been taken lightly. Presumably this means his party had been planning it for some time. The decision was quietly announced on a day when the House of Commons was not sitting and with no mention from Jeremy Hunt in any of his own previous comments.

Social care is on its knees. If the comment in Alistair Burt’s letter that the Care Act has “people needing care at its heart” is to be believed, the government will hopefully now do the right thing and stop short of cynically taking back back the money local authorities have received to implement the reforms. Local authorities are already at breaking point.

Alistair Burt’s letter also has a heavy focus on the development of the private insurance market, and states that it is not suitably developed at this point to allow the Care Act reforms to go ahead. That’s hardly breaking news – it’s been evident for some time. It suggests the Care Act was either underfunded from the start, and/or the government never intended to see all the measures through in the first place.

Indeed, the Community Care blog highlights how two councils challenged the Dept. of Health on the lack of adequate funding to implement the Care Act. Not wanting the case to expose the structure of underfunding, the Dept of Health settled out of court.

Away from social care and in the wider NHS it’s not hard to see which way things are going. Funding towards some vital services, including those involving the voluntary sector, seems to be ending as personal health budgets become more widespread and people are told to find their own care services.

Plans for Greater Manchester’s devolved health and social care spending powers have excluded the voluntary sector, something that has always been integral to a state-funded health and social care system.

Youssef El-Gingihy’s Huffington Post article, How To Dismantle The NHS, paints a grim picture for anyone who believes in the original values of the NHS. In the article, the GP pinpoints how the NHS is being privatised and turned into a private insurance model of healthcare.

If the cap on social care fees and the new means test threshold do finally come into effect from April 2020, this will be just five weeks before the next UK general election. Who knows what false promises will be made – and broken – then?

15 Comments

  1. James 1 year ago

    My father had a severe stroke 5 years ago. He is completely paralyzed down his left side , doubly incontinent , has trouble talking , has severe dysphasia also has a PEG tube fitted to his stomach which he receives meds and food through. He has had 4 NHS CHC assessments upto now. All which have been unsuccessful. We lost our mother two and a half years ago which clearly has affected our father. He is very withdrawn. The last meeting we had we received a letter from CHC on day of our meeting to say ur father didn’t qualify even before assessment had took place. We have another meeting for NHS CHC in two weeks time but just see it as a waste of time. Its like you have to be at deaths door to qualify.
    Many Thanks
    James

  2. Linda 1 year ago

    Some of you may not like this comment, but here goes. My mother has been in care for six years. She has deteriorated to the stage where she is room bound, has not been load bearing for two and a half years, doubly incontinent, totally vacant in expression, has to be fed and everything is done for her.
    During a hospital stay, in June 2013, I managed to get her assessed for NHS funding on the last day of her stay before moving her to a nursing home (she had been in a care home that could no longer provide for her needs). This was successful and she was awarded the funding. Up until then she had been self funding. I now feel guilty that she is not paying anything for her care and her financial situation is increasing while the NHS is supposedly, if we believe the media, to be in dire financial straits. If she was in her own home she would be paying utility bills and having to pay for food etc. I feel that she should be paying something towards her board and lodging, even if it was only £200-£300 per week. I am not sure how much the NHS pays for her care but it was £700 per week when she moved in, although the care fees would have been £900 if she was paying herself.

    • Author
      Angela Sherman 1 year ago

      Thanks very much for your comment, Linda.

  3. David 2 years ago

    Following the Barker Commission on the Future of Health and Social Care in England, all of the main political parties seem extremely keen to merge social and health care. On the record the idea seems to be to make it easier for users of both services to have a single point of contact, making the process seamless and quicker (in theory at least) for users to access the care they need. However, the sub text seems to be to cut out much of the duplication and waste in the current system and, hopefully, save money.

    Very little seems to have been said publically about what would happen to NHS Continuing Healthcare if HM Government were in future to enact legislation merging the health and social care systems. I understand the Barker Commission recommended that NHS Continuing Healthcare should cease to exist and all users of the new system would be subject to the vagaries of means testing.

    Is this true? If it is true is anyone talking to our politicians to explain the consequences and lobbying them to come up with alternatives.

    It is clear insurance companies have no interest whatsoever in providing insurance cover at sensible premiums to for people who, by pure happenstance (as successive prime ministers have noted), find that because they have developed a particular illness(es) they have a primary health need, a need which at present would be covered by NHS Continuing Healthcare.

    • Author
      Angela Sherman 2 years ago

      Those are good questions, David. If health and social care are merged and local authorities given more responsibility for it, the chances are that more care will be means tested – because it will be erroneously labelled ‘social’ care.

      • David 2 years ago

        Thanks Angela

        I believe the situation is far worse than that, and that our politicians would actively welcome being able to do abolish NHS Continuing Healthcare completely to save money.

        The integration of health and social care is inevitable. But there is no reason whatsoever why the social care system should be given primacy over the health care system in the event of a merger. And certainly not to save money. Unless of course that is what the electorate at large wants.

        At the moment no one is talking to our our politicians, the media or the public at large to educate them about the consequences (both intended and unintended) of merging both systems, and making the case to keep the safety net of NHS Continuing Healthcare (or its equivalent) so those who through nothing more than sheer bad luck become ill enough to be deemed to have a “primary health need” (under the present system) do not have to sell everything they own to pay for their care.

        The British people have forgotten what the health and social care landscape was like before 5 July 1948,

        The United Kingdom needs another Aneurin Bevan. Now more than ever!

        “No Society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”

        “It will last as long as there are folk with the faith to fight for it”

        “Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community”

        Aneurin Bevan, founder of the National Health Service

        • Author
          Angela Sherman 2 years ago

          I wouldn’t be surprised if there is a hidden agenda at play that may seek to do away with CHC. Indeed, I believe Lord Warner suggested it should be means tested – which of course completely ignores the fact that CHC is NHS funding and cannot be means tested. Unless there is a change in the law, of course…

          • Chris-G 2 years ago

            Yes this is a very disturbing development that was entirely foreseeable once the current Gov got in.
            The organisations called Commissioning Support Units that “assist” CCGs are all ready for privatisation next year. It is all in hand. Our CSU controls health services for circa 10 million people. It is run by the person that advised the Government with regard to the 2012 changes to the NHS CHC process. (Nice present for him?) His minions also seem to create rules on the fly with regard to CHC locally and for those within that 10 million person catchment area. Soon they will do this as a profit making high salaried board of directors.

          • David 2 years ago

            To be fair HM Governments of all political persuasions have been angling towards integrating health and social care for many years, with the NHS deciding an increasing number of what were historically “health” services being shunted over and deemed “social care” services (and therefore means tested).

            I understand earlier this year the Scottish Government abolished NHS Continuing Healthcare Support for anyone who isn’t being treated in hospital (commentators have indicated it is hoped this swinging change in policy will be challenged in the courts at some stage soon). Logically there is no fiscal reason why the Westminster Parliament would not attempt to do something similar for England in order to “balance the books.”

            A number of charities i have been in contact with claim that are fighting the corner of the most vulnerable in society to ensure that NHS Continuing Healthcare Support is kept in place, but reading between the lines, and as a former student of politics, i would expect these organisations to be the last to be told that a political policy decision had been taken to do away with NHS Continuing Healthcare.

            The electorate at large are simply not aware of possible hidden agendas, particularly in this so called “age of austerity”. As for privatisation of the NHS, there are a dwindling number of people alive today aware of just how dire the health of the British nation was before 5 July 1946.

            And it seems insurance companies have no interest whatsoever in providing individual private health insurance at anything like sensible premiums, because there is no money to be made.

  4. Michael 2 years ago

    Perhaps the state should run and staff their own care homes, (as they used to), hospital like if necessary, to avoid feeding the fat cats.

  5. V Williams 2 years ago

    I could not agree more – it is an absolute disgrace. My mother 98 has only just died after a long hard fought battle with dementia following a series of strokes. She self funded for the five and half years she was in a nursing care home and for care in the home prior to this. It was obvious that her fees (over £900 p.w.) were helping to ‘subsidize’ the other Local Authority patients. Her bungalow had to be sold to fund ‘her care’. She was turned down for NHS Continuing Healthcare Funding on the grounds her needs were not complex! She could do nothing for herself, was doubly incontinent, chair/bed bound with leg strictures, suffered from severe dysphagia, was in mental distress and eventually starved/dehydrated to death! It has been horrific – she/we deserve much better! We must all ask what future now for our care as we age/decline. It is absolutely scandalous. It will be too late for us to take out appropriate affordable insurance to cover our care needs and most of our children are struggling financially in rented property – so what for their future?

    • Author
      Angela Sherman 2 years ago

      Those are good questions. In just one or two generations time, far fewer people will have property assets to sell. And then what?

      • Chris-G 2 years ago

        Yes, Angela. As you wrote, “and then what?”
        I cannot believe that so many Governments of different colours over the last 60 or so years have failed in so many aspects of the foreseeable future to understand simple arithmetic…… so what chance them actually being able to plan an entire economy. The only other explanation is that it is entirely deliberate.

        We are now expected to fund our adult children and now even grandchildren too, finance our elderly parent’s care and save for our pensions and our futures whilst paying a mortgage too….. Likely, not even a small inheritance at the end of it either. Not bad going for an alleged social society!
        Not good at all, for the majority of that group that have always paid tax but never even earned the national average wage, more recently perhaps suffering zero hours contracts and age discrimination in obtaining work or promotion too.

  6. Alex Bowen 2 years ago

    Absolutely disgraceful, yet another broken promise and a waste of taxpayers money from a Government that spins lies and wastes precious money.
    It is time we all woke up, I am surprised there is not protests about this and more reporting by the media.
    It goes to show the government wants the elderly vote but once they have it they don’t care a jot and will lie and deceive once they are in power.

    • Chris-G 2 years ago

      Ditto Alex, I second everything you wrote.

      I pointed out many years ago that the, as then, largely unchallenged CHC assessment process was easily convertible to assess others in society……
      …. Such as those that have had agro with benefits assessors. The sick are subjected to very similar but computer scored domains and again it is nurses and physio therapists that decide the matter of someone’s health needs and incapacities and therefore their need for sickness benefits and Industrial Injuries Compensation payments. The decision makers are the DWP of course; but when under pressure and with cost saving staff reductions, how many decisions do they actually make?

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