By Leon A Smith
February 14, 2013
It’s always startling to see the extent to which the government find it necessary to leak/trail the announcement of any new policies in an attempt to soften the impact of a stark announcement in parliament. The coalition government’s response to the recommendations of the Dilnot Commission would surely win a prize for the “All time greatest leak”. It was leaked extensively, repeatedly and with a very considerable degree of accuracy. Therefore when the news was announced in parliament on Monday, we already knew everything that there was to know. I have long been extremely cynical at the attempts of successive governments to stall on the question of funding long term care by setting up repeated commissions of enquiry and then sitting on the often unpalatable results of those enquiries. That’s what happened with the Royal Commission in the late 90’s and to a lesser degree that’s what’s happening now. The coalition government came into power in 2010, yet any changes to the funding system will not take place before 2017 – which is after the next general election. Who knows which party may be in power at that time!
Notwithstanding this and not wishing to be churlish, the government’s acceptance of some of the principles of Dilnot are to be welcomed – the principles being (a) a cap on any one individual’s liability for fees; (b) a raising of the absurd and artificially low limit at £23,250 – above which people have to pay for their own care. I would like to examine first the £75,000 cap. The first thing to recognise is that this is not a “cap”. It’s £75.000 plus the costs of what might be termed as “hotel costs” – a combination of food etc, which could easily come to another £15,000 per annum. If for example somebody were to stay in a care home for 3 years, the real costs to the individual would therefore be £120,000. Jeremy Hunt has said that “nobody will have to sell a property”. The detail has not been published and therefore it is difficult to understand exactly how this is going to be achieved.
Many people paying fees in care homes do not have assets of any significance other than their property. Quite how somebody in their late 80’s is suddenly going to raise £120,000 is something of a mystery! There was a vague hint – details of which have not yet been specified – that perhaps the government or more likely local government will “cash flow” the care paying the fees on behalf of the client so that they do not have to sell their home and later claim back what is owed to them from the estate when the client passes on. It is heartening to think that by 2017, local authorities will have sufficient cash to be able to do this.
Having said that I have welcomed the government’s response – indeed, any response is welcome after so many years of inaction – I still believe there is an element of smoke and mirrors at play here. I return to the £75,000 “cap”. Would one be able to make a free choice that that £75,000 should be spent in one year in the most luxurious and the most expensive care home in London? That would be great news because it would mean at the end of the year the government would effectively pick up the tab for care. Somehow I don’t think this is what the government have in mind. The reality of what they are going to be doing is “have a cap of £75,000 but this cannot be spent at a rate of more than a certain sum – for example £30,000 per year”. The effect of this of course is to elongate the date by which local authorities will have to take responsibility. If somebody really did want to go into a care home that would cost £75,000 a year, then they would presumably then have to pay the difference between £30,000 and £75,000 themselves, regardless of the cap. (I do hope, reader, that you are still following me!).
From a care home provider’s point of view and particularly a charity such as Nightingale Hammerson, this is not good news. What it means is that effectively clients who are currently ineligible for local authority support are now paying us a “full” rate. Once they have reached their “cap” the local authority becomes involved. The local authority will then be paying us at their rate which is going to be very different and certainly very much lower.
For those of you who may not be following this somewhat technical discourse, the bottom line is that from the perspective of the charitable provider, we are going to be receiving less money from clients across the board. Again, this therefore, puts further pressure on charitable providers who have no other means of generating income beyond this other than seeking charitable donations from the community.
We await to see details of the proposals and of course we also await to see whether this government will return to power in 2015. Having said that, criticism from the opposition has been somewhat muted and in my view it is unlikely that a Labour government will move a 1,000.000 miles away from this policy.
For the avoidance of ambiguity, I state my case. The news of some activity in this long neglected area is welcome. Rather sadly, it’s too little and it’s coming much too late.