Councils should lose responsibility to the NHS for long-term care funding to reduce costs, a think-tank close to the prime minister said today.
In a report aimed at influencing the new care funding commission, Policy Exchange recommended that the NHS should administer all funds for long-term care for older people. Care would not be free at the point of need, but the principle of users funding their own care should be extended to the NHS.
The report said the proposal would encourage more integration than current methods and would include joint appointments across health and social care, ending the “artificial and self-imposed” divide between two sectors that were “largely interdependent”.
It urged the Commission on the Funding of Care and Support, set up last week to help forge a new settlement on long-term care funding, to consider the reform.
The centre-right think-tank was formerly chaired by education secretary Michael Gove and has long been a big influence on Tory thinking.
Report author Henry Featherstone said, under the proposals, consortia of GP practices would commission social care for older people, alongside healthcare, which they will take responsibility for in 2013 under the government’s health White Paper, published this month. Local authorities would provide social care alongside the independent sector.
Featherstone said: “The boundaries between what the GP consortia are expected to be and local government are going to be increasingly blurred and you shouldn’t artificially divide the [health and social care] budgets at the top and try to recreate them at the bottom.”
The report said the reform was needed to control NHS costs in an era of austerity.
It found that the NHS was already spending about 4% of its budget (£4.23bn) on older people’s social care, including NHS continuing care and services to people with reduced mobility in hospital. It said this figure rose by 67% between 2007-8 and 2008-9 as the NHS picked up the tab from tightened eligibility criteria in councils. This figure was likely to rise as councils faced spending cuts of 25% from 2011 to 2015.
The report also rejected other proposals to reform the care funding system, describing Tory plans to allow people to pay a one-off premium of £8,000 to insure themselves against residential care costs as “unrealistic”. It said this was more likely to cost individuals about £40,000.
It said that free personal care funded out of general taxation, as was introduced in Scotland in 2002, could cost the government up to £106bn each year – equivalent to funding a second NHS.
It recommended instead that the funding commission consider models combining state with individual funding for care.