Anyone catch Brown's conference speech today?
He made a shock pledge (well it was a shock for me at least) to introduce free personal care for older people with critical care needs receiving care at home, with the Department of Health finding £200m to implement the policy in its first year from October 2010.
A few questions arise to me though you can probably think of several more.
Still it's a big policy proposal on social care in one of the biggest political speeches of the year.
Do people buy it?
As a quick response, I think that setting the level at 'critical needs' is going to rule out most people who need domiciliary care for the first part. To be honest, I wish I think it would be better to broaden the levels of support so that more could be done for those with substantial and moderate needs rather that focusing on the headlines that 'free personal care for the elderly' will gain a political capital.
Perhaps I'm just a little sceptical but while the Green Paper is looking at funding options, I have to wonder where the money will come from.
Good blog on this today cb - there do seem to be a lot of question marks against the policy - (I had a good response to my blog on this about the pressure it will put on care managers, from service users and their families, to ensure they are assessed as critical, and implicitly from councils to ensure they are not).
On the preventive side, do you think this could - perhaps perversely - incentivise councils to invest in prevention somewhat more than they currently do to ensure people don't reach the critical stage? (I'm now wondering whether that is in fact the policy intention).
Though obviously, on the converse side, as Age Concern and Help the Aged has pointed out, it could create a perverse incentive for councils to place people in residential care.
Very odd given the green paper consultation still has six weeks to run, as you say. In terms of the funding I've read - though need to check this obviously - that there will be money recycled from the NHS budget to meet most of the cost - spending on advertising, management consultants etc.
Transferring NHS funding (so long as it's not frontline case) does seem welcome though pre-empting (at least in part) the green paper consultation sits oddly with the idea of a Big Care Debate.
The truth is, whenever policy has tried to push local authorities in a particular direction (I'm thinking about the NHS and Community Care Act here) they have managed to wangle out different outcomes than those intended - indeed, that's the basis of the FACS criteria in the first place. We were only ever supposed to be responding to need but because need was so broadly defined (and so costly) it had to be narrowed down into bands.
I'd love to think it would encourage preventative work but I'm more concerned about the amount of money it is going to take away from the 'system'. To be honest though, I think the likelihood of there being a labour government in power to take it through is minimal so it's something of a moot point.
I've been banging on about prevention needing more focus for years though so it just gives me another outlet for it. I think the Age Concern/Help the Aged worries aren't going to be too evident as it is almost always cheaper for someone to be funded at home than in residential/nursing care unless they are funding themselves!
In any case, it is very very rare for someone to be forced into residential care against their wishes (although it is possible - indeed, I've been responsible for some of those particular instances myself I'm sorry to say). At least the Mental Capacity Act serves as a safeguard, as do the new Deprivation of Liberties Safeguards.
I have absolutely no doubt that there will be unforeseen consequences. I'd love them to be a greater focus on prevention but I am not overly hopeful.
I know that getting services for free should be a wholesale 'good thing' but I'm just a little worried that it doesn't seem to connect up. There is, as you noted as well, the difference between treatment of younger and older people - no doubt that will be raised and should be.
I've worked in over 65s services pretty much since I qualified and have constantly been battling against age discrimination - and I don't see any reason to stop, just because those being targeted are under 65 now.
The proposed new policy does nothing for those who are forced to sell their homes in order to pay for care in residential/nursing homes. Twelve years ago Tony Blair said he didn't want his children to grow up in a country where this happened. Maybe the Blairs have moved abroad?
Just to let you know I've add a couple more details cleared up on this since I last posted on it:-