Council leaders have questioned Gordon Brown’s plan to introduce free personal care at home for older people with critical needs, as it emerged that councils would be expected to find £250m a year to fund the policy.
The Association of Directors of Adult Social Services and Local Government Association said there were a number of unanswered questions about the announcement, and that they would seek talks with the Department of Health to work through the implications.
The DH said yesterday that the policy would cost £670m a year to implement, with the department contributing £420m and councils expected to find the rest from efficiency savings. It is expected to apply to upwards of 350,000 people.
Under the government’s plans, the policy would come into force in October 2010, at least four months after the next election and almost four years before the planned introduction of more far-reaching reforms to the care funding system, on the back of the current green paper.
Adass president Jenny Owen said she welcomed the prime minister’s announcement but was “cautious about adding to the burden of local authority efficiency savings”.
This was because while to date efficiencies had been used to bridge the gaps between local authority funding and the rising demand for services, it was a new development for them to be used to fund new services.
Andrew Cozens, the LGA’s group strategic lead for adult social care, said the policy would be popular with service users, but added that the predicted cost was “highly speculative” because of the lack of information on people who currently pay for their care in full.
He said “eyebrows” would be raised among councils about the expectation that they should find further efficiency savings from existing budgets, especially given evidence of mounting pressures on adult services in government figures published today on social care spending in England.
These showed that councils increased spending on adult social care by 5% in 2008-9, more than the 4% cash rise in government grant for local authorities.
Compatability with personalisation
Cozens also said there were questions about the compatability of the policy with the personalisation agenda given that it would provide a national entitlement to a particular service. Conversely, with personalisation, the emphasis is on users making choices about the support and services they require following assessment.
Their concerns about funding and the lack of detail as yet on the policy were echoed in other responses to the announcement.
Niall Dickson, chief executive of the King’s Fund, said the “devil will be in the detail” for the policy and echoed concerns raised by Age Concern and Help the Aged that councils could have a perverse incentive to usher older people into residential care to avoid paying for free care.
He also expressed surprise at the announcement given that the idea of free personal care was seemingly rejected in the government’s adult green paper, published in July, and the consultation on the green paper still has several weeks to run.
Residential care question mark
Julia Unwin, chief executive of the Joseph Rowntree Foundation, said it welcomed the proposal, but added: “Not all older people live in their own homes, raising questions about what support there will be for those who live in care homes and other settings.
“This pledge is only one small step towards creating a long-term care funding system that is fairer, more sustainable and fit for everyone.”
Stephen Burke, chief executive of Counsel and Care, was also supportive, saying it would give “thousands and thousands of older people the choice to stay in their own home rather than move into residential care” but warned that it had to be properly funded.
- Have your say on the proposed policy on CareSpace.
- Read our blog on the announcement.
- Read social worker cb’s blog on the issue.