DH survey reveals depth of public ignorance about care funding

A Department of Health survey has revealed widespread public ignorance about how the care system in England is funded.

It found that 31% of people believed social care services would be free if they needed them, with similar results across all socio-economic groups. This was despite the fact that most people with at least moderate means must pay for care.

The DH also found that 68% of people believed they would need to sell their homes to enter and pay for residential care, despite this not being the case. Local “deferred payment” schemes allow councils to recover the costs of care from people’s estates.

The survey of 1,750 adults, which took place in August, was designed to inform the DH’s thinking on its green paper on the long-term reform of care funding, due next year.

Over the past six months, the DH has held an “engagement process” to raise public awareness of the impact of demographic pressures and rising expectations on the future costs of care. The process closes today.

Age variations

The DH survey found that younger age groups were more likely to believe care would be free should they need it, with 34% of 15- to 24-year-olds and 39% of 25- to 34-year-olds holding this view.

However, 33% of over-65s also thought care would be free should they need it.

Older groups were more likely to believe they would have to sell their homes to pay for residential care, a view held by 72% of over-65s, 78% of 55- to 64-year-olds and 79% of 44- to 54-year-olds.

Likelihood of needing care

The DH also found that 18% of people thought they would not need care services in future, with 23% of 15- to 24-year-olds holding this view. Around one in four people need care in older age.

DH director general of social care David Behan said the “level of ignorance about the way the care system works is very high”.

The department held five “citizen events” during the engagement process with 400 members of the public.

Behan said people were “quite taken aback by the fact that one in four of us will need care in our later years and that one in five of us is likely to get dementia”.

Behan added that people had not thought about the rising “dependency ratio” and its impact on the affordability of care. The ratio measures the number of retired people to workers, which has risen from 1:19 to 1:4 over the past century.

Two systems

Behan also said that the DH was considering the case for establishing two systems of care funding, one for adults of working age and one for retired people.

He said younger adults often wanted the care system to help them find work while older people expected services to provide dignity and help them maintain independence.

Leonard Cheshire Disability called last month for separate systems for users lacking assets, who were often younger disabled people, and people who had wealth they could draw on to pay for care. However, Help the Aged said this proposal would lead to discrimination against older people.

Although Behan’s distinction was based on people’s desire to work, rather than possession of assets, he stressed having two systems was compatible with equality, which did not mean “treating people the same”.

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