Government plans to establish a national care service for England would reduce the role of local authorities in funding care.
Under the plans, announced today, the Department of Health would set a national eligibility threshold for care, in which all those who had difficulties with three or more activities of daily living, such as dressing or washing, would receive a state contribution to their funding.
This would replace the current Fair Access to Care Services guidance, under which councils can set one of four thresholds for care – critical, substantial, moderate or low – in line with their budgets.
Today’s green paper said that in future, the DH would determine a single eligibility threshold though it is unclear how this corresponds to the current FACS bands.
It would also specify what proportion of care costs would be funded by the state and what proportion would be met by individuals. People would be eligible for an equivalent level of support when they moved between local authority areas, ending the current situation where users have to undergo a new assessment when they move.
However, the government is consulting on whether councils should be able to vary how much they spend on people for a given level of need or whether this should be set nationally.
The former option would allow councils to take account of the different costs of care in different areas, due to wage levels and other costs, and is likely to be backed by the Local Government Association.
The green paper said the latter option would involve public funding for care being met entirely out of general taxation, rather than partly through council tax.
The DH admitted that a fully national system could make it more difficult for councils to tailor care and support to local circumstances, and mean people in higher-cost areas may not be able to afford as much support as those in lower-cost areas.