DH official says far-reaching reform necessary on adult care

Reforms to adult social care funding in England on the back of the recent green paper must be far-reaching to be effective, members of the London Assembly were warned this week.

Alexandra Norrish, who led the Department of Health team that produced the green paper, told a session of the assembly’s health and public services committee that its proposals were necessarily radical.

She added: “The time for fiddling around the edges with this little bit and this little bit is over. It’s an issue that isn’t going to go away.”

National care service

The green paper, published in July and now under consultation, proposed creating a “national care service” in which people would have the same entitlement to care wherever they lived and all eligible users would have some of their personal care needs funded by the state.

It also proposed three funding options for financing the remainder of people’s personal care costs:- a partnership model, in which people would be left to fund the remainder; an insurance model in which those who paid into an insurance pot would have their costs met from it; and a comprehensive model under which people would have to pay into a national insurance scheme.

In all three the poorest would have all of their care costs met from general taxation.

Joint working a necessity

The committee was also told that joint working, between all health and social care professionals was necessary for the proposed system to work. 

Andrew Webster, senior associate at health and social care think-tank Kings Fund, said joint working often achieved better results but in the rush to respond to government directives was frequently lost. “The green paper will not solve this problem but if it is not solved it will not work,” he said.

Counsel and Care policy and communications manager Caroline Bernard said the organisation backed the comprehensive model outlined in the green paper. However, she said this would need to be implemented in a fair way which neither penalised or forgot any one group.

State insurance preferred

Speaking on who should take responsibility for any care insurance scheme, Webster said, “When you ask the public they would generally prefer the government to hold the money than a private company.”

The green paper’s proposal to effectively abolish attendance allowance to provide extra funding for the social care system has come under criticism from a number of disabled people’s groups, who have warned this would people would have less control of their own care.

At the committee meeting, Norrish acknowledged there was strong support for attendance allowance but also pointed out the advantages of reform, adding: “What we are trying to do is take the strengths of the two systems and combine them into one.”

Consultation on the green paper will close on November 13.

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