The social care sector has applauded the government’s plan to create a national care service in today’s social care White Paper, referring to it as bold and a milestone. However, many commentators have expressed concern at the lack of specific proposals to fund the service.
Jenny Owen, president, Association of Directors of Adult Social Services
“There is still much anxiety, given the burgeoning economic difficulties facing public services, and we shall be looking closely at the government’s impact assessment and figures to see how the plans have been costed. But there can be no doubting the proposals’ far-reaching ambition, nor the difference they would make, if fully achieved, to the quality of life of hundreds of thousands of people.”
She warned: “There are no guarantees that this White Paper will see the light of legislative day, nor that the principles and objectives it embraces will be achieved in the timescale set.”
Stephen Burke, chief executive, Counsel and Care
“The White Paper provides a road map and clear direction towards better care for the next government. Straight after the election all parties must work together to decide on the best way to pay for a comprehensive national care service. Counsel and Care believes that the risks and costs of care should be shared collectively across the population. We shall be pressing for a funding solution that is fair, simple and sustainable. Clearly the next government, whoever is elected, cannot do nothing. What can’t be escaped is that we will all have to pay more for better care.”
Carole Cochrane, chief executive at The Princess Royal Trust for Carers
“Establishing a universal entitlement to free care and support for those who need it will lift many families out of caring roles, which are currently unsustainable and lead to ill-health, isolation and poverty. The government has always recognised, however, that the UK’s six million unpaid carers will continue to make a huge contribution to any National Care Service. This contribution is much larger than the state’s, and it will be of much greater value than any amount that families will be asked to contribute in cash, through payment into either the government’s proposed comprehensive care insurance scheme, or the Conservative’s proposed optional care insurance scheme.
“Our current system of assessment gives families less state support, the more they provide for themselves. All proposals on the table will continue this. The Secretary of State has heralded the addition of more free support, but this will not be on offer to those families who wish to continue to provide their own care. This must be addressed, or the rate of people dropping out of unpaid caring roles will increase dramatically, which will make any proposals announced today unaffordable.”
David Congdon, head of policy, Mencap
“We are concerned that at this stage there is still no sustainable, long-term funding plan for social care – even after two consultations. A funding plan needs to be decided as a matter of urgency. We would also like to see a representative for disabled adults of a working age on the proposed leadership committee responsible for making decisions about funding – these adults’ needs have been sidelined as a result of the recent focus on the older generation during the political debate.”
Allan Bowman, chair, Social Care Institute for Excellence
“We are very pleased that this important White Paper has been published today. It’s ambitious and signals a bold next step on the improvement journey for care and support services in England. We are pleased that this paper has clearly been significantly influenced by listening to the public through the Big Care Debate and the discussions which followed last year’s Green Paper. We have maintained throughout that questions about who pays for adult social care are vital but that it’s equally crucial to ensure that social care services are cost-effective, personalised and delivered by a well-supported, skilled workforce. “
Dame Jo Williams, chair, Care Quality Commission
“We have been arguing for clear national standards for people’s entitlements to care, no matter where they live, and that their assessments of needs should be portable if they move. In our State of Care report in February we called for a fundamental culture shift in health and social care to achieve joined-up services and give people more choice and control and support their independence.”
Ruth Sutherland, acting chief executive, Alzheimer’s Society
“People with dementia are some of the hardest hit by the existing system of charging for care which can burden families with a ‘dementia tax’ of tens of thousands of pounds. Proposals to share this load have to be welcomed. The suggested two-year cap on care home fees could be particularly beneficial. Also the setting of national entitlements and quality guarantees give us hope that substandard care can become a thing of the past.
“This is an ambitious plan and if all political parties work together it provides a real opportunity to turn around the social care crisis we currently face. However this will take time and we now need information of how the immediate funding shortfall is to be met.”
Amanda Redmond, chief executive, Carers UK
“Family carers desperately need these reforms as many are pushed to breaking point due to lack of support from the current system. This White Paper places carers at the centre of social care – recognising that a new National Care Service will not take care away from families, but would support them. The government has recognised that the demographic challenge of an ageing population makes a National Care Service an economic imperative.
“We also welcome plans for a new commission to decide how individuals pay into the proposed social insurance scheme. Given the political point scoring on these issues in recent weeks, it is vital that these questions are dealt with on a consensual basis. Although the vision is clear and ambitious, the White Paper in itself does not contain enough detail on the question of funding. The promised commission on funding must be brought forward as a matter of urgency, to deliver on the specifics, and give families confidence that the sort of care system they need will become a reality.”
Anna Dixon, acting chief executive, The Kings Fund
“The White Paper leaves a number of key questions unanswered. What level of need will be covered? How much is it going to cost and who will foot the bill? The absence of any costings makes it difficult to assess how affordable these plans are and how sustainable they would be in the long term. Our own analysis suggests the introduction of free personal care would see net public spend rise from £10.7bn in 2015 to £16.8bn in 2026.’
“We welcome a staged approach but this will only work if detailed proposals are set out without delay. While political consensus is vital further deliberation could slow down the momentum for reform.
“We will face increasing demographic need. Whoever wins the next election must ensure that reform begins as soon as possible.”
Emma Stone, co-director policy and research, Joseph Rowntree Foundation
“Today’s White Paper proposals set out a clear vision for a national service and funding system that has the potential to meet these criteria, and this must be commended.
“Much work needs to be done in the next parliament about exactly how people will pay for this system. Ideas allowing each generation to pay for the costs of its own care in later life are already on the table”.
“At a time when tough decisions need to be made to reduce the public deficit there is a huge risk of a loss of momentum on this debate. We urge all the major parties to work together and build public consensus to ensure we have a fair and equitable system in place to deal with one of the biggest challenges of our time.”
Alan Long, executive director, Mears Care, a longstanding domiciliary care provider
“The obvious unanswered question is how will a comprehensive model be funded? Whatever model is finally decided upon, it’s vital that Government and local authorities do not lose sight of the savings and improvements that can be gained through joining up budgets at local level between social care, health policy, and other policy areas, such as housing.”
Steve Barnett, chief executive, NHS Confederation
“We have significant concerns about the further delays in implementing a long-term solution. What is absolutely vital is that the opportunity presented by a cross-party commission after the election is taken and that there is no loss of momentum on this issue. Long-term funding for social care, the provision for our elderly and infirm, is one of the greatest challenges we face as a nation and it is crucial that we get it right.”
Margaret Eaton, chair of the Local Government Association
“It is a step forward that we have been listened to, and the importance of local councils in delivering top quality care has been recognised. The LGA has long argued that providing the best support for older and disabled people depends on a good knowledge of what’s needed in different areas and the varying services which are on offer. It is not possible to respond to the very different needs of individuals on a one-size fits all basis.
“Councils want to be able to offer appropriate help and support to every single resident who needs it, but sadly the funding available hasn’t kept pace with this ambition. Addressing this is of the utmost importance.”
Stephen Jack, chair of trustees, Independent Living Fund
“The ILF already brings the critical elements of national consistency, portability of support, and links to the benefit system, to the locally driven arrangements that otherwise
characterise care funding in the UK. These are central features of the new proposals.”