NHS Confederation moots social insurance for adult care

The NHS Confederation has suggested that adult social care should be partly funded by social insurance to relieve long-term demographic pressures.

In a contribution to the current debate on the future funding of care, the confederation, which represents NHS bodies, backed a similar financing model to that proposed by Derek Wanless in his landmark 2006 report for the King’s Fund.

State-funded entitlement

Under this, everyone deemed eligible would receive a state-funded minimum care entitlement which they could top up, with the government meeting the contributions of the least well-off. In addition, some care-related benefits – such as disability living allowance and attendance allowance – could be rolled into the care system.

Like Wanless, the confederation said the current means-tested system penalised people with savings. For instance, those with assets of more than £22,250 could not access publicly-funded care in England.

However, it warned that people needed to start saving now to meet the costs of top-ups to their minimum entitlement, saying that “our children may not be able (or willing) to pay the bill for our future care”.

Commissioning services

Instead, it said that a social insurance system – under which people make contributions into a single pot, from which they can draw in times of need – could fund top-ups, whether by being linked to pensions or to a separate contributory system.

The NHS Confederation paper also raised questions about local government’s future role in commissioning social care. It suggested that with the development of individual budgets and different methods of funding, service users themselves, insurance providers or even GPs may take on this role.

The paper is designed to inform the expected public consultation on the funding of adult social care, ahead of the promised green paper this year.

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