Page last updated at 08:14 GMT, Friday, 12 March 2010

Social care under-funded and rationed, say MPs

By Nick Triggle
Health reporter, BBC News

Elderly man
Care funding is currently means-tested

Adult social care in England is "chronically under-funded" and "severely rationed", MPs say.

The Health Committee warned urgent action was needed and told the political parties to stop their point-scoring and seek solutions instead.

The cross-party group said if politicians failed they would "betray current and future generations".

Ministers are expected to set out their plans for reform of the £16bn system in the coming weeks.

The challenge facing social care is the perennial problem of supply and demand. While the NHS budget doubled in real terms over the last decade, social care funding rose by little more than 50%.

It has created a situation where councils have responded to more and more requests for help by restricting access to services, leaving vulnerable people to decide between struggling along on their own or selling their homes to pay for residential care.

In truth, the social care system was only ever created as a safety net. The expectation was that a large proportion of caring would be done by relatives and friends, but with community and family life now very different from the 1940s that has become less likely.

Politicians have responded by calling for a "partnership" between the state and individuals. That, of course, requires people to dip into their own pockets, creating an explosive issue in the run up to the election.

Social care, which includes support provided by councils to people in their own homes for things such as washing, eating and dressing as well as residential home placements, is now at the top of the political agenda.

Last summer the government put forward three options for change - one of which involved charging people a compulsory levy of up to £20,000, which has been dubbed a death tax by the Tories.

In recent weeks, the row has escalated with the parties launching attacks on each others' policies.

Two summits have been held in the last month alone, but still no consensus has been reached.

But the committee said it was essential agreement was brokered early in the next parliament so as not to "betray current and future generations".

The report said reform was long-overdue, pointing out it is 13 years since Tony Blair announced changes would be made.

In that time, councils have been placing more and more restrictions on who can get access to care.

Three quarters of the 152 local authorities with responsibility for care now only provide services to those with the highest needs.


What is more, the means-tested threshold, which stipulates that anyone with assets of more than £23,000 has to pay for their care, was unrealistic, the MPs suggested.

They point out that the actual cost of care on average, certainly of care homes, was much higher.

And without reform, the situation is only going to get worse because of the ageing population, the MPs said.

Labour - Put forward three proposals - all of which involve the state providing a basic level of care which would be topped up by either personal contributions, a voluntary insurance scheme or compulsory levy. The third option - dubbed a death tax - is said to be favoured by ministers
Tories - Proposed an £8,000 voluntary insurance model to cover residential care costs. Now drawing up plans for a voluntary scheme to cover domestic care, such as help washing, eating and dressing in the home
Lib Dems - Initially supportive of free personal care - like Scotland has introduced - but now want a "partnership" whereby state pays some and individual tops this up. Open to compulsory levy

However, they pointed out that the baby-boomer generation will not hit their mid 80s until the early 2030s, creating what they claimed was a "window of opportunity" to improve the system.

Committee chairman Kevin Barron added: "We don't want this issue to be turned into an election football for it to be kicked back into the long grass again in a few weeks."

And as an interim measure, while the system is being reformed, he said the £23,000 threshold should be raised so that more people could get access to care.

Mr Barron also said general taxation should not be ruled out as a way of funding social care - all the options being considered at the moment involve some state funding, coupled with individual contributions.

Stephen Burke, of Counsel and Care, a charity for older people, said: "This sets out in clear terms why we need reform. The three parties now need to meet the challenge."

Care services minister Phil Hope said a white paper setting out how the system should be changed and funded in the future would be published soon.

He added: "Fixing our system of care for people who are older and disabled is our very highest public service priority."

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