Adass: DH has ‘significantly underestimated’ free care cost

The government has “significantly underestimated” the costs of implementing free personal care for people with high needs, according to a survey published today by the Association of Directors of Adult Social Services.

Adass is seeking urgent talks with the Department of Health, after its poll of 61 authorities found that the true cost of the policy to councils could be more than double government estimates.

Its concerns have been echoed by the United Kingdom Homecare Association, as the House of Lords prepares to debate the Personal Care at Home Bill for the first time on Monday.

The DH has said the legislation would cost £670m a year to implement – £420m from the department and £250m from local government efficiency savings.

However, Adass said its survey had suggested the true cost could be at least £1bn, making the overall cost to councils well over £500m.

Under the bill, 277,000 people would benefit from free care at home, including 111,000 who now pay for services, out of an estimated 1.8 million care users in England.


The bill’s other measure – to provide reablement services to people entering the care system – would benefit an estimated 130,000 people a year, and cost an estimated £130m a year.

In its impact assessment for the bill, the government said it had calculated the costs of free care at £103 per person per week – 6.54 hours of care at a cost of £15.75 an hour.

However, Adass’s survey found authorities had calcluated the average as £200 a week.

Adass president Jenny Owen said that there were other costs on top of this because the number of existing self-funders in any given area – and the number who would qualify for free care – were often unknown. Councils would also face greater costs from the increased number of assessments they would have to carry out.

She added: “If the final policy means that people with critical care needs will not have to contribute to their care needs regardless of the cost, then funding pressures on local government will clearly be well above the sum estimated by government.”

In a briefing for the House of Lords, the UKHCA said that not only would councils struggle to find the £250m in efficiency savings specified by government, but the impact assessment may have significantly underestimated the costs and the number of users who would claim free care.

It warned a lack of funding would lead councils to slash fees for independent providers, putting downward pressure on wages and exacerbating the already high rates of turnover in the sector.

Support for the bill

However, yesterday a group of charities representing older people, carers and disabled people called for politicians to throw their support behind the bill.

The organisations, which included Carers UK and merged charity Age Concern and Help the Aged, said the people they represented would not “forget if the opportunity was missed to end unfair charges for those most in need”.

The Personal Care at Home Bill will receive a “forensic examination” in the House of Lords, according to Labour peer Lord Lipsey, who has been highly critical of the proposals.

The DH is currently consulting on guidance and regulations with which to implement the bill, a process that runs until 23 February.

A spokesperson said: “People tell us they want to stay independent by living in their own homes for as long as possible. That is why we are taking forward plans to offer free personal care at home for those with the highest needs regardless of their means. We are in the process of consulting on aspects of the bill and will feed Adass’s new contribution into this.”

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