Ivan Lewis: Eligibility system needs shake-up but rationing to stay

By Mithran Samuel on June 25, 2008 in Adults, Older people, Social care leaders

Care services minister Ivan Lewis has said the current adult care eligibility criteria system should be overhauled but a system of rationing is unavoidable.

Addressing a conference on the issue organised by Community Care and the Voluntary Organisations Disability Group, Lewis said the current system needed to be reformed because of inconsistencies in access to care and the exclusion of people with lower-level needs from support.

However, he added: “You have to have some level of eligibility criteria.”

CSCI review
Lewis ordered the Commission for Social Care Inspection to review the fair access to care services (FACS) system after the regulator’s third State of social care report exposed widespread inconsistency in within and between areas and the poor outcomes of those excluded from council-funded support.

CSCI’s figures have shown that from 2005-6 to 2007-8, the proportion of councils restricting care to those with “substantial” or “critical” needs rose from 53% to 72%. Under FACS, people with substantial needs are unable to carry out most personal care tasks and are at risk of neglect or abuse.

CSCI director of strategy David Walden, who is leading the review, said it had so far found strong support for eligibility criteria in more than 100 written submissions and among nearly 3,000 respondents to an online questionnaire.

No return to “free for all”
He said that people did not want to return to the “free for all” in access to care that existed before FACS was introduced in 2003.

Walden said the review’s challenges included reconciling eligibility criteria with the government’s drive to make the care system more personalised and preventive; the balance between nationally determined rights to care and local flexibility, and ensuring consistent decisions within and between councils.

The review is due to report to ministers in September and will be published shortly afterwards. Walden suggested it would recommend short-term changes, with any long-term reforms dependent on next year’s green paper on adult care funding.

Improvement and Development Agency strategic adviser for children, adults and health services Andrew Cozens emphasised the importance of universal community services such as transport in mitigating people’s need for social care.

He warned: “People are paying their council tax and shouldn’t be taxed twice by having to spend their personal budget on universal services.”