Nuffield Trust responds to the publication of the social care White Paper

Responding to the publication of the social care White Paper, draft Care and Support Bill and progress report on funding, Nuffield Trust Chief Executive Dr Jennifer Dixon CBE said:

‘Today’s White Paper is a step forward for now. For example national eligibility criteria for receipt of social care will help reduce the gross postcode lottery that exists today, but how will stretched local authorities pay for any extra care now needed?

‘If there is no new money there could be more radical ideas as to how the existing £140 billion of state funding of older people (care and other welfare payments) could be rejigged to fund more social care. For example by withdrawing some universal benefits from the wealthy. Or by pooling budgets and provision across NHS and social care and aligning incentives better between both. After all, a lack of social care is threatening the viability of NHS services across England.

‘It is welcome that the Government has agreed with the principle set out in the Dilnot Commission report of a lifetime limit on costs any individual has to pay. Yet a concrete way forward still has not yet been decided. Plans to make universal the scheme in some local authorities to defer an individual’s bill for social care until after their death, to be paid from their assets, are welcome.

Many people think that when they are old and frail there is a national NHS-like system of free care to support them. There is not. Nuffield Trust Chief Executive Dr Jennifer Dixon CBE

‘But much more progress needs to be made and quickly, since the number of ageing baby boomers means the challenge of supporting this generation is rapidly growing larger. How to pay for care for this large cohort of people, fundamentally how much should individuals pay versus the state, is not any clearer.

She added:

‘Many people think that when they are old and frail there is a national NHS-like system of free care to support them. There is not. They fail to plan because their needs may be unpredictable, they are not well informed about care availability, eligibility and cost, and local arrangements for care may be very complex. Meanwhile local authority social services budgets are stretched meaning that state-funded social care is only available to the very needy.

‘The result is that people with assets above £23,250 must pay for care, which in some cases means selling their home (and spending most of the proceeds if their needs are great), while others go without needed care. And there is gross unfairness across the country as local authorities have different eligibility criteria for receiving state funded social care.

‘Because of the lack of planning, the stress on families, carers and friends is great. And the often poor support for older people leads to costly yet avoidable admissions to overstretched hospitals, where the quality of care for the most vulnerable is at risk (as evidence to the Francis Inquiry is showing).

‘Today’s publication is a start, but more progress cannot wait until the next spending review whenever that proves to be.’