It would be a pity if the Government’s latest proposals for a National Care Service were submerged in electoral sloganeering. It is a hugely important issue, with enormous implications for millions of people in the years ahead, but it requires a broad public consensus. There are several alternative proposals on the table, and the key issues of course in each case is how many mainly, but not exclusively, elderly disabled and infirm people will be covered and how will the scheme be funded.
As a comparison, the current system of social care for older people is projected to cost £8.1bn in 2015, rising to £12.1bn by 2026. The problem with this system is that it covers far too few elderly people in real need. It only covers those with a means-tested income, excluding their house, below quite a low level, and in most local authorities only those in ‘critical’ need of care, not even those in ‘substantial’ need, let alone those who are still in need but in less severe categories.
A so-called partnership model, whereby the State would pay 50% of the cost plus £1 for every additional £2 that individuals pay for themselves, is projected to cost £10.1bn in 2015 rising to £15.5bn by 2026. This would increase the coverage by almost two-thirds and would halve the extent of unmet need by 2015 – good value for money at an extra £2bn cost.
A third option, ‘free personal care’, would raise the cost by 2015 to £10.7bn and by 2026 to £16.8bn. The disadvantage here is that, whilst it covers costs fully, it would apply to only a very small core of people in the very highest need category – around 2% of pensioners.
Unfortunately it’s impossible to judge between the latest proposals put on the table just over a week ago – the Government’s National Care Service and the Opposition’s home protection scheme – because no detailed figures are given. They would both remove the strongly felt objection of the better-off that they stand to lose their homes if they need extended care, but by the same token the schemes offer more of (now extremely tight) public spending to those with most resources which is not a scheme focused on need.
Once the election is over, this should command the attention of the new Government as one of their most urgent priorities.