Adult green paper: Government outlines national care service

The government today proposed to establish a national care service in which anyone who meets a new England-wide eligibility threshold will be entitled to some state funding for their personal care.

The long-awaited green paper on long-term care funding would end the exclusion of current self-funders from state support and scrap councils’ ability to set care eligibility thresholds.

However, public funding would not increase. Instead, the Department of Health has proposed to use money currently spent on Attendance Allowance, which is paid to all older people with care needs, to fund the new service.

The DH proposed that the state should fund a minimum of a quarter to a third of the care costs of those in need, with more state funding for those with less wealth.  It also put forward three models for how individuals would contribute to their care costs:

  • A partnership model in which individuals would be left to fund the costs themselves as they arose;
  • An insurance model in which people would be invited to pay into a state-backed insurance scheme which would meet the costs;
  • A comprehensive model in which everyone who reached retirement age paid into a state insurance scheme regardless of whether they went on to need care.

The DH said each proposal would end the current situation in which some people were required to spend upwards of £200,000 on long-term care. The national care service would not meet the costs of accommodation in care homes, although people of low means would continue to have these costs meet.


Disability organisations welcomed the green paper but warned it could be a “lost opportunity” as there was no time for legislation to underpin it before the next general election.

Mike Smith, chair of the National Centre for Independent Living said: “Disabled and older people were hoping for leadership from the government in care reform. This has come now in a new vision for how we support individuals to become full and equal citizens. But the green paper provides few concrete plans. Instead, it is an options paper, requiring further debate and development before any reforms can be implemented.”

In a joint response, NCIL and RADAR said they were also worried that nationally run funds like Attendance Allowance, ILF and DLA could become administered by local councils as a result of the green paper.

Liz Sayce, chief executive of RADAR, said: “The 1997 Labour Manifesto stated ‘community care is in tatters’ and reform is overdue. There is much to welcome in the green paper. We need a system that enables disabled people to have a life – on our own terms. Now is the time to accelerate progress and deliver reform.”

Mark Goldring, chief executive of Mencap, called on the government to ensure that people with learning disabilities were not overlooked: “Mencap welcomes the green paper and fully supports the government’s agenda to transform social care and its recognition that the current system has failed to provide people with a learning disability and their families and carers the support they need.

“With social care debate firmly focused on older people and how much people pay for their care, people with a learning disability are often get a raw deal. Establishing a funding system that strikes the right balance between individual and state for older people, will fail to address the needs of people with a learning disability who need life-long packages of care and rarely have any savings.”

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