State-funded free personal care for all has been ruled out by the commission tasked with reforming the care funding system, on the basis that it is unsustainable.
Andrew Dilnot, chair of the Commission on Funding of Care and Support, revealed the decision in an interview with Community Care. Although it will not come as a surprise, it is the first time Dilnot has ruled out free personal care as an option.
The news will come as a disappointment to many disability campaigners who support making social care free at the point of use, along the lines of NHS treatment.
However, Dilnot said: “We are sure that just a state-funded free care system isn’t going to be the answer. We are not going to be recommending it. It will not be resilient enough or sustainable enough if implemented.”
Personal care is free for older people in Scotland, but there are concerns that it is proving too costly there and that it places an unfair burden on working-age taxpayers, who would fund care largely for those over 65.
Dilnot said the commission would put forward a “partnership” approach, which would draw resources from the state, individuals and informal carers to ensure people have affordable access to support. Such a system would be underpinned by insurance.
A partnership scheme also received strong backing from among the 250 responses received during the commission’s recent call for evidence, he said, with responses coming from individuals, affected organisations and the financial services sector.
However, Dilnot would not be drawn on whether the commission had ruled out introducing a compulsory levy for care, following comments to this effect from fellow commissioner Lord Warner.
Warner, a former Labour health minister, told a conference last month that the idea of compulsion “doesn’t feel to me as though it fits the public mood music at the moment, or the mood music for the foreseeable future”.
Many experts have said a reformed system would have to be underpinned by compulsory insurance because there was little evidence from other countries that a voluntary scheme would have sufficient take-up.
However, Dilnot said: “Once you accept that, [the partnership principle] then the distinction between compulsory and voluntary is of little consequence. At the moment there is some state, private and also some informal care. We will see elements of that in any provision.”
The commission, which also includes Care Quality Commission chair Jo Williams, is now refining its ideas while also commissioning modelling on areas such as unmet need for care.
It is due to issue its final report in July, which will inform a White Paper this autumn and legislation next year on reforming the care funding system.
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