Two-year delay to cap on care costs on cards, amid fears reform will be dropped altogether

Times reports that government will delay adult social care charging reforms until 2025 in autumn statement, as part of money-saving drive

Rishi Sunak
Rishi Sunak (credit: HM Government)

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The government will delay the introduction of the cap on care costs for two years, in chancellor Jeremy Hunt’s autumn statement next week, The Times has reported.

The measure is designed to contribute to government plans to make expected reductions of over £30bn a year in spending to shore up the public finances.

Delaying the £86,000 cap and the associated reform of making the means-test for care more generous, from October 2023 until 2025, would save about £2bn. If the government also delayed its accompanying drive to ensure councils paid providers a fair cost of care, it would release a further £1.2bn from 2023-25.

The government had been reportedly planning a one-year delay, but the latest Times story says that prime minister Rishi Sunak has pushed for this to be doubled.

While council bodies had expressed support for a delay of up to a year, this was in order to give the sector time to prepare fully for their introduction, including by recruiting sufficient social workers to carry out the many thousands of additional assessments required. It would also allow more time to learn from the six trailblazers who are due to trial the reforms over the coming months.

Councils ‘must retain money if reforms delayed’

Organisations including the Local Government Association, County Councils Network and Association of Directors of Adult Social Services also argued that the funding allocated for the reforms should be retained by councils during any delay, to invest in pressured social care services.

However, the news has sparked concerns from sector leaders that the reform will be dropped altogether and it is unclear whether any of the funding released would be retained for social care, given the government’s priority of saving money.

In the wake of today’s Times story, the LGA’s community wellbeing board chairman, David Fothergill said: “A delay to the social care reforms would mean that government has time to learn from the trailblazers and ensure that the funding and support is in place for councils and providers to ensure a successful implementation.

“If the government decides to proceed with a delay it is crucial that the funding allocated towards the reforms should still be available to address inflationary pressures for both councils and providers and to begin the move towards paying a fair price for care where possible, although without further funding this will be difficult to achieve. This funding alone is not sufficient to address the issue of care worker pay and rising demand for services.”

‘Risk of services going under without emergency funding’

Martin Green, chief executive of provider umbrella body Care England gave a similar message, saying: “We have waited over 30 years for a long-term funding settlement for social care. If the government is going to delay this further, they are going to have to provide some emergency funding for the sector immediately.

“If they do not, they will see lots of social care services go under,  and then they will understand the importance of social care because they will have a social care and NHS crisis on their hands.”

Age UK charity director Caroline Abrahams said that while the proposed reforms fell “way short” of ex-prime minister Boris Johnson’s 2019 pledge to “fix social care”, it was “at least a start and something to build on for the future”.

The cap and extended means-test was first proposed by the Dilnot Commission, in its 2011 report on reforming social care funding, which the then coalition government pledged to introduce in 2016. This was then delayed and, eventually, scrapped altogether by the Theresa May government, only to be resurrected last year under Boris Johnson.

‘Lost decade for social care’

Reflecting this, Abrahams added: “If the chancellor does announce next week that he is kicking it into the long grass, probably to disappear altogether, it will mean we have endured a lost decade or more where social care is concerned.

“Millions of older and disabled people have had to put up with inadequate services over that period, and committed care staff have soldiered on despite miserly terms and condition. Meanwhile, millions of unpaid carers of all ages have put their own interests aside and helped support their loved ones, often feeling they had no other choice.”

Social care commentator, and former social services director, Richard Humphries issued a similar message on Twitter, saying delaying the cap would further defer consideration of the sector’s biggest challenges.

‘Damaging blow’ for people with dementia

King’s Fund senior fellow for social care Simon Bottery said there was a “compelling case” for pressing ahead with the cap as it was critical to enabling people to plan for their older age, and would give confidence to insurance companies to design products to help people cover their £86,000 liability.

And, while acknowledging the scale also said it was “naïve to think that delaying or abandoning the cap will automatically mean the funding tap is turned on for social care in other areas”.

Meanwhile, Alzheimer’s Society raised concerns about the impact of the delay on people with dementia, for whom the reforms would reduce the risks of facing catastrophic care costs.

“Government must not roll back on the care cap,” said the charity’s associate director of advocacy and system change, Mark MacDonald. “This social care reform was a crucial first step to tackle catastrophic care costs, limiting the amount people had to pay towards their care. People with dementia are the biggest users of social care – at least 70% of care home users have dementia – and this delay would be a damaging blow  at a time when many of them will be struggling with bills and need action on the cost of care too.”

Hunt will deliver his autumn statement on 17 November.


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3 Responses to Two-year delay to cap on care costs on cards, amid fears reform will be dropped altogether

  1. Stephen Corlett November 11, 2022 at 8:14 pm #

    There are probably differing views about how high the priority should be of achieving the objective of these reforms – protecting older people with assets from the “catastrophic costs” of moving into a care home – in comparison with addressing some of the other pressing issues facing adult social care. But if it is confirmed that there is to be a delay of two or more years, that creates an opportunity to consider whether the same objective couldn’t be achieved in a way which creates less of a burden on the already stretched capacity of local authorities, and doesn’t risk creating chaos in the care home sector by trying to unwind too quickly the peculiar funding arrangements that have developed over the past three or four decades – cross-subsidies, top-ups, “lifestyle supplements”, etc. The worst outcome would be for there to be a delay of two or three years, and then another hasty attempt to implement the same set of changes. Local authorities have now twice come close enough to implementing the Dilnot proposals to be confronted with the riskiness and impracticality of changing the system that rapidly in that way. In a rational world we would now be rethinking whether there’s a better way to do this.

    • Nick Kaye November 17, 2022 at 10:35 pm #

      Uncapped care costs destroy people’s lives – the current system reduces many disabled people and older people to living in poverty because their clinically driven needs are deemed beyond the remit of the NHS. The comment above does not recognise the sheer scale of uncapped costs and how few can afford them.

      • Stephen Corlett November 18, 2022 at 2:38 pm #

        As my comment said, there are differing views about the priority of capping charges – my comments above were about the mechanism rather than the policy. A mechanism which risks destabilising local authorities and the care home sector doesn’t benefit anyone, and the Dilnot mechanism is not the only way to achieve the Government’s policy objectives.

        Arguably, too, issues about affordability and people being reduced to living in poverty are more relevant to the part of the current charging system which is based on people’s income, rather than the part based on their assets – and the charging reform proposals that have now been deferred were almost entirely about assets (though, after what would in many cases be a decade or more, some people paying charges on the basis of their income might eventually have hit the cap). Typically (though of course not always) charges paid from assets primarily impact on the amounts which family members of service users will inherit, whereas income-based charges directly affect the disabled person’s day-to-day disposable income.