Sue Collins: long term care champion moves on

Sue Collins left a strong legacy at Joseph Rowntree Foundation with a policy for long-term care funding that is informing government thinking. Now at charity WRVS, she spoke to Jeremy Dunning

While Sue Collins was involved in developing long-term care funding policy, a personal experience gave her a new perspective on the complexities of the system.

Collins, the former policy and research manager for the Joseph Rowntree Foundation’s long-term care programme, says caring for her mother, Hilda, who died last year, gave her an insight into the problems faced by many people.

Collins, who last month left JRF to join older people’s charity WRVS, says: “My mother was a self-funder but she had the same problem a lot of people face –how do you navigate your way through the system? I struggled to do it and I’ve got a master’s degree. It’s the lack of advocacy and advice – it’s hard to know where to find help.”

Now, as regional lead for the WRVS, she is focusing on how older people can be supported to live independently at home and receive good, affordable services.

Links with partners

Collins, 54, has been involved in social care since the 1970s, spending 20 years in London before moving to Glasgow to run a community support service for people with mental health problems and learning disabilities. But she is best known for her work during her nine years at JRF, where she became an influential voice on long-term care funding in England.

This was a non-issue politically when JRF started to look at it in 2000, a year after the Royal Commission on Long Term Care for the Elderly reported. Gradually this has changed – partly because it could no longer be avoided, but also because the JRF and Collins forged links with partner organisations and policymakers to build momentum based on evidence.

The shift culminated in last year’s green paper, Shaping the Future of Care Together, which will be followed shortly by a white paper on funding reform.

Some of the evidence gathered by Collins has come from other countries, including Japan, Germany and – with its free personal care model – Scotland.

Under Japan’s social insurance system, all workers aged 40-65 contribute to a fund to meet the care costs of eligible users over 65 and those over-40 with age-related disabilities. All beneficiaries contribute a co-payment of 10% of the value of their care.

A co-payment system was among five proposals for reform made by the JRF in a paper published in 2007 (see below) that has influenced policymakers and politicians.

Costed solutions

Collins says providing costed solutions has been an important part of the JRF’s work, adding: “We’ve never gone to government making demands for more money and instead have focused on trade-offs.”

The ideas were updated in March 2009 and packaged as immediate solutions that would put the care system on a fairer footing in time for more radical reform.

One area in which the JRF has made particular progress is equity release, which enables homeowners to use part of the value of their home to meet domiciliary care costs and support.

It is piloting a scheme with Kensington and Chelsea and Islington councils in London and Maidstone Council in Kent, and a report on the project is due out later this month.

During Collins’ time, the JRF has also run consultation events in York and Bradford to encourage generations to mix and get younger people thinking about their future support needs. However, Collins says too many people assume that care is free at the point of need.

Public awareness

With a general election looming, she says a lot of the good work triggered by last year’s green paper seems to have been lost amid “political posturing” and policy announcements such as the Personal Care at Home Bill.

The bill, which would introduce free personal care at home for people with high needs, has been accused of undermining the green paper’s vision.

Collins says that if she were to start her role at the JRF now, she might focus more on raising public awareness than on forging partnerships.

But she adds that she feels “very proud of the work that I was able to do at JRF to use our robust evidence base to shape debate”.

Biography: Sue Collins

1978: Worked in London, mainly for local authorities, as a social worker.

1995: Moved to Glasgow to work for Richmond Fellowship Scotland.

2000: Moved to York for JRF post.

Family: Married with two sons. The eldest is a part-time care worker and student.

JRFs funding solution

● Equity release, allowing older homeowners on low incomes to pay for home-based care by deferring the costs until their home is sold.

● Higher capital limits for care home fees to help those with modest assets.

● Doubling of the personal expenses allowance for people living in care homes supported by local authorities.

● Free personal care for more people in nursing homes to extend public coverage of care costs.

● Payment by the state of a fixed percentage of all core costs, with individual co-payments funding the rest. This would radically redistribute public resources spent on care.

More on the JRF’s work on long-term care

This article is published in the 14 January issue of Community Care magazine under the heading The voice of long term care funding