Andrew Dilnot’s much anticipated report into the funding of care and support has finally been released this morning. Key points are that care costs should be capped at £35,000, food and accommodation costs should also be capped and the means test threshold should be raised from 23,500 to 100,000.
Dilnot argues that this will mean that no-one going into care should have to spend more than 30% of their assets. The scheme he claims will cost £1.7bn a year, an affordable one four hundredth of total public spending (£700 billion).
There’s no doubt that the finding of adult social care is one of the most pressing political issues of our time. Life expectancy in the developed world rises by about two years every decade (equivalent to your death receding by about five hours every day).
As we live longer, more and more of us will spend longer periods of our old age needing significant amounts of care. The Dilnot commission found that people were frightened of this prospect because they did not know what costs they would face. So it’s pleasing that Dilnot also supported a Law Commission proposal for councils to be given a statutory duty to provide advice on care.
Press coverage of the report has naturally focused on the national picture and on the potential costs of Dilnot’s recommendations as a proportion of national spend, but in reality this issue is most pressing for local government for whom adult social care is their biggest area of expenditure by far.
Councils directly fund about 59% of those in care but they also end up funding about 25% of those who initially fund their own care once they deplete their resources and fall back on the state. Independent Ageing, a recent report by the Local Government Information Unit (LGiU) supported by Partnership found this ‘hidden‘ cost to be up to £1 billion a year nationally. Dilnot’s proposals will increase the cost of state funding but should make it more predictable by ensuring that fewer self-funders run out of money.
Dilnot suggests that the cap will allow an insurance market to expand to fund care home places, pooling the risk among a wider group and reducing the numbers forced to sell their homes. A better market for insurance to meet care costs is exactly what LGiU argued for in Independent Ageing but this relies on people receiving advice from appropriately qualified independent advisors. Local authorities would be helping their citizens and their own financial interests if they connected people with such advice: but at present only 3% of them do so.
It remains to be seen how the government responds to Dilnot’s recommendations. Media speculation is that George Osborne is not very keen on the extra £1.7 billion spend. We should get an early indication when Paul Burstow, the Minister of State for Social Care, addresses the All Party Parliamentary Group for Local Government on Wednesday.
Irrespective of the national response, however, there are already simple steps that can be taken at a local level to ensure that people get advice on how to manage their finances and reduce the chances of them falling back on state funded care. That’s a financial issue of course, but it’s also, most crucially, a way of giving people self-determination and dignity in the old age that’s an increasingly common destiny for us all.