Adult social care funding has become a significant issue over recent years for four main reasons:-
- Public spending has failed to keep up with demand for services.
- Public expectations of the quality and personalised nature of services are growing.
- There is a sense that the system of funding is unfair because of a postcode lottery in access to care between local areas and because people with savings above a certain threshold do not receive state funding for residential care, outside Scotland.
- Demand for care is set to increase significantly over the coming years as the population ages and with the ever increasing life expectancy of disabled people. The number of people in need of care in England is expected to rise from six million in 2009 to 7.66m in 2030, according to the Personal Social Services Research Unit.
Public spending cuts and unmet need
Local authorities in England are receiving significant cuts to their funding from 2011-15 on the back of the 2010 comprehensive spending review. The Association of Directors of Adult Social Services has estimated that English councils will cut spending on adult social care by £1bn in 2011-12 and expects the total cut to be greater in 2012-13.
This has manifested itself in rising charges on users for care services and increases in eligibility thresholds. It also builds on evidence of existing unmet need for care. Age UK has estimated that, as of 2011, 800,000 older people in need of care in England were not receiving formal care services and that the number will rise to over one million from 2011-15.
In Scotland and Wales, cuts to adult social care appear to be less deep but are still likely to be significant.
The Dilnot report and long-term reform
In July 2011, the Dilnot commission, commissioned by the UK government, published its report on the long-term reform of social care funding in England. Its main proposals were:-
- A national system of assessment and eligibility to end the postcode lottery for care.
- A £35,000 cap on the lifetime costs of care for individuals whose eligible needs for services arise after they turn 65.
- Lower caps on the lifetime costs for people who acquire needs at earlier ages. Free care for those who acquire needs before they turn 40.
- A £7,000-£10,000 annual fee for the board and lodging costs of people receiving residential care.
- A rise from £23,250 to £100,000 in the means-test savings threshold above which people are ineligible for state funding for their care.
The proposals would cost £1.7bn a year to implement and the government will respond in a White Paper by April 2012.
Scotland and Wales
Scotland, unlike the rest of the UK, provides all eligible people, regardless of their wealth, with free personal care in care homes and at home. There are no plans to change this despite concerns about the pressures on council budgets that the policy has created.
In Wales, a weekly cap of £50 on care charges for individuals receiving services in the community was introduced in April 2011. By contrast, in England, many councils removed maximum weekly caps on care charges and increased fees for services such as home or day care in 2010-11.