CILL

The Government wants to set up a National Care Service providing:

• Prevention Services
• National assessment
• Easy assessment process
• Information
• Personalised care and support
• Fair funding

That sounds great and what we all want but the difficult questions are who should pay for it and also what is the best way of using tax money.

The Green Paper sets out 5 different options for funding:

• Pay for yourself – The Government does not think this system would work because many people could not afford to pay and those who did have savings would have to spend everything they had.
  
  
• Partnership - In this system, everyone who qualified for care and support from the state would be entitled to have a set proportion – for example, a quarter or a third – of their basic care and support costs paid for by the state. People who were less well-off would have more care and support paid for – for example, two-thirds – while the least well-off people would continue to get all their care and support for free. A 65-year-old in England will need care and support that costs on average £30,000 during their retirement, so someone who got the basic offer of a third or a quarter paid for might need to pay around £20,000 or £22,500. Many people would pay much less. And some people who needed high levels of care and support would pay far more than this, and would need to spend their savings and the value of their homes. This system would work for people of all ages.
  
  
• Insurance – In this system, everyone would be entitled to have a share of their care and support costs met, just as in the Partnership model. But this system would go further to help people cover the additional costs of their care and support through insurance, if they wanted to. The state could play different roles to enable this. It could work more closely with the private insurance market, so that people could receive a certain level of income should they need care and support. Or the state could create its own insurance scheme. If people decided to pay into the scheme, they would get all their basic care and support free if they needed it. People could pay in several different ways, in instalments or as a lump sum, before or after retirement, or after their death if they preferred. Once people had paid their contribution they would get their care and support free when they needed. As an indication of the costs, people might need to pay around £20,000 to £25,000 to be protected under a scheme of this sort, compared with the average cost of care for a 65-year-old which is £30,000. This system would work for people over retirement age. However people paid, the insurance payment would help people to protect their wealth and the value of their homes. Whether they decided to pay during their working life, during their retirement or after they died, people would know that once they had made their contribution and paid for their accommodation, the costs of their care and support would not prevent the rest of their wealth being passed on to their children.
  
  
• Comprehensive – In this system, everyone over retirement age who had the resources to do so would be required to pay into a state insurance scheme. Everyone who was able to pay would pay their contribution, and then everyone whose needs meant that they qualified for care and support from the state would get all of their basic care and support for free when they needed it. It would be possible to vary how much people had to pay according to what they could afford. The size of people’s contribution could be set according to what savings or assets they had, so that the system was more affordable for people who were less well-off. Alternatively, if people wanted to be able to know exactly how much they would have to pay, most people other than those with lower levels of savings or assets could be required to pay a single, set figure, so that people knew how much they would have to save for. As an indication of the costs, people might need to pay around £17,000 to £20,000 to be protected under a scheme of this sort compared with the average cost of care for a 65-year-old which is £30,000. The cost would be less for people who were over 65 when the scheme was introduced. However people paid, the insurance payment would help people to protect their wealth and the value of their homes. Whether they decided to pay during their working life, during their retirement or after they died, people would know that once they had made their contribution and paid for their accommodation, the costs of their care and support would not prevent the rest of their wealth being passed on to their children. This system would only work for older people as they reached retirement age so we would also look at having a free care and support system for disabled people of working age alongside this.
  
  
• Paid for out of tax money - Everyone gets their care and support for free but to meet the cost everyone would have to pay more tax. The Government does not think this system could work because there would be fewer working age people paying a lot of tax for a bigger group of older people. They also think it would be unfair as older people are already the richest age group in the country (in the value of their houses).

There is also a proposal that ‘disability related benefits like Attendance Allowance’ are stopped and that money used towards the cost of care services. It is not clear if that extends to Disability Living Allowance (DLA) and the Independent Living Fund (ILF).

CILL is concerned that none of the proposals relate specifically to younger disabled people so we have no clear idea of what we would get. There seems to be an understanding that younger disabled people get free support already and that will continue. This is not true for many – all are means tested and reduced to income support level plus a small ‘buffer’, those who worked lose their savings, occupational or private pensions, all have to justify what they spend (for example, heating costs), many cannot get the support they need and most are reduced to living in poverty. If DLA and ILF are taken away then more will move into poverty reducing even more our choices and life chances.

We now have until mid November to respond to the proposals and following that the Government will decide which option to take forward. Any changes or proposed changes may well be affected by next year’s general election and in any event will take some years to put in place.