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Dilnot Report on Adult Social Care Published
With our elderly population ever increasing, the Government commissioned Sir Andrew Dilnot to make recommendations regarding the future of the social care system in England. The long-awaited report was published this week. It comes at a time when local authorities are slashing their own social care budgets, and the private care sector has had to accept lower fees, although the true cost of care is steadily rising.
With a population that is growing at a rapid pace, social care funding needs a radical overhaul so that it will be fit for purpose in the future. Many people find themselves struggling or unable to pay for their own care or that of a relative, so additional support is needed to ensure the welfare of the aging population and that nobody is left vulnerable and alone in old age.
It has been established throughout the report that funding has not kept pace with demand. The current funding system for social care is widely perceived as unfair, as some individuals lose most of their assets when care packages are being considered. The current system is under-resourced, and many people are not receiving the care and support they need. It has long been recognised that the system is highly variable across the country and within local authorities. It is currently based on the needs assessments of individuals undertaken by multi-disciplinary services, some of which do not work well together, causing shortfalls in care provision for the most vulnerable people in society.
The reforms outlined in the proposal would reduce the costs individuals face in old age, by calling for a national eligibility threshold with portable assessments.
However this would involve the current Government agreeing to develop a more objective assessment scale, which is coherent and aligned to care and support, with enhanced integration between health and social care . This in turn ought to produce an improved alignment of the assessment processes between social care, disability benefits and health.
The outline proposal of this report put to Government by Sir Andrew Dilnot is that each individual would fund their own care costs up to a maximum of £37,000, which would be capped once this amount had been reached. The Government should then take over the responsibility of funding future care, and that the threshold at which individuals start paying for their own care should be raised from the current £23,000 to £100,000.
Since publication of the report, Sir Andrew Dilnot has conducted various interviews regarding his recommendations, speaking on Radio 4, he said: ‘I think the system is broken and at the moment people are frightened about something they ought to celebrate. We should be delighted that we are expected to live longer and longer. The risk of high care costs is the one big risk that all of us face, (and) where we have no way of preventing the extreme risk. If we have a healthcare problem, the NHS looks after us. If our house burns down or you have a car crash, then we will have taken out private insurance. In England the state does not cover you and the private sector will not. So at the moment people face an uncertain risk and it makes them very, very frightened, and they feel powerless. What we are proposing is that we set a cap of £37,000. If your costs are more than £37,000, the state will kick in.”
The proposals set out above would cost around £1.7 billion a year to implement, rising again by about a half as England’s population ages. The treasury has released figures suggesting the true cost could be as much as £5 billion a year. This is likely to cause problems for the Government, as paying for this could mean raising taxes or making cuts in other areas. The Prime Minister, David Cameron, admitted that the report had been kicked into the “medium high grass” while the party tried to build a cross-party consensus on the next steps.
Leading charities, which include Age UK and the Alzheimer’s Society, plus other experts, signed a letter last week to the Daily Telegraph warning that any dilution of the recommendations could be disastrous. They said “It would be catastrophic if the forthcoming report from the Dilnot Commission resulted in no action at all. We are reaching crisis point. We know there is no perfect solution. Care will always cost money and someone has to pay for it.” They have also called on the Government to accept the proposals, fearing that political wrangling would mean that the proposals may be watered down or even ignored.
The recommendations laid out in the Dilnot report have already started to strain the relationships within Government. Although they have been quick to deny this, Andrew Lansley the Secretary of State for Health, has emphasised that the issue of how to pay for social care must be cleared up before any action is taken. John Healey the Shadow Secretary of State for Heath, stated that this is “a once in a generation” chance to reform the care system and “end the fear of ageing”. He called on the Government to work with the other parties to make sure that real reform of care services can happen. “The Dilnot report is a good start, what matters now is what the Government does”.
It is agreed by all that reform of social care and funding is urgently required, and it will be in the long term interests of everybody that there is a unified commitment to implement the changes necessary, and to not allow politics to get in the way of improving the social care system.
This in turn will assist providers of social care in both the public and private sectors to maintain the Essential Standards of Quality and Safety that are part of the Health and Social Care Act 2008 (updated 2012).
With a sustainable resource and funds needed to ensure a good quality of life wherever we may be in our twilight years, the events of the coming months following the publication of the Dilnot Report will be of critical importance to everyone.