If we’re coughing up for the social care levy, the reforms need to build new foundations
Once again social care is in the headlines and, once again, it’s about arguments and bad news. The government’s proposals for a cap on a person’s lifetime care costs from 2023 met a lukewarm reception when they were first announced in September. People were looking for more targeted investment and wider reform that would make a difference not just to how people pay for their care, but in the quality and availability of services.
Now, the reception is set to turn even colder. On Monday evening, several Conservative MPs rebelled against the subtle but important changes made to the fine print of the social care cap which, in short, means people with lower-valued assets – a house, for example – will be worse off.
Many will find that, if they do end up needing long-term care, they will use up most of their savings and house value before they hit the £86,000 point when the government steps in to take over paying. Previously, the Government had promised “no one would need to sell their home to pay for social care”. This has, fairly, been the centre of the social care debate. But what happens when people do wind up needing support is just as important.
People will already be acutely aware – as the price of petrol, energy and everyday shopping soars – that they will be paying for this much-vaunted plan to “fix” social care through a health and social care levy on their national insurance payments. It would be understandable if they lost faith in efforts to reform social care.
But we should hold on to the prospect of reform. While the government’s proposals are not the big stride forward that people might have wanted, they do still make progress. In particular, the changes to the means test will see people who have up to £100,000 in assets getting some help with their care costs.
The government has said this will benefit an extra 75,000 people. And even the altered cap will provide a degree of protection that does not exist now.
These are also proposals that can be built on in the future. Reform happens slowly, and it will require successive governments to push for change.
This week, the King’s Fund set out a “radically realistic” vision for social care. It would lead to genuinely significant improvements which rest on structures and reforms that have already been set out by the government. There are four key principles of a good social care system: availability of services, personalisation, quality and eligibility.
With all of the talk of levies and caps, it’s easy to forget the value of social care. There is a good reason for that too: there is an unwillingess to admitting that we are going to get old, and need help.
But even for those not directly using social care, there is an intrinsic value in the jobs created, the pressure it takes off the NHS (thereby improving access to regular medical services), and the personal responsibility we have for our loved ones.
The watering down of the proposed reforms is disappointing.
It remains a real problem that even with extra money being taken out of people’s pockets, not enough of that is going to ensure social care is on a sustainable footing. But, there is an opportunity to start to build the foundations of a sector which doesn’t just deliver for more people, but delivers the care people actually need.