Labour is still committed to implementing the cap on care costs and related reforms to adult social care charging, the shadow care minister said yesterday.
Andrew Gwynne told the Association of Directors of Adult Social Services’ (ADASS) annual spring seminar that, should the party win the forthcoming election, it would “seek to introduce” the changes first conceived of by economist Andrew Dilnot in a 2011 report for the then coalition government.
The current government is also committed to introducing the reforms, in October 2025, two years later than originally planned.
‘Significant risks’ to reforms
And less than 18 months out from the target date, the DHSC has not published any plan for implementation or set out how it would find the money to finance the changes. This casts significant doubt on whether it will start the process of implementation before the election, which is likely to take place by November 2024 at the latest.
The DHSC originally allocated £3.6bn over three years to implement the changes.
What the proposed changes consist of
- Putting an £86,000 cap on people’s lifetime liabilities for their personal care, based on how much the person’s council would – or does – pay for meeting these needs, except where the person is receiving means-tested support, in which case only their individual contributions count towards the cap.
- Implementing section 18(3) of the Care Act 2014, enabling self-funders to request that their council arrange a care home placement for them, enabling them to benefit from the typically lower rates councils pay for care, compared with private payers. This would ensure that the costs that count towards the cap are those that the person actually pays.
- Funding councils to pay providers a ‘fair cost of care’, to avoid the implementation of section 18(3) and the removal of the ‘self-funder subsidy’ making providers unsustainable.
- Raising the upper capital threshold, above which people are charged for their care, from £23,500 to £100,000, allowing many more people to claim state-funded support. The lower capital threshold, below which people make no contribution to their care from their assets, would rise from £14,250 to £20,000.
However, in 2022, it decided to delay the reforms by two years and ploughed most of this money (£3.2bn) into shoring up existing adult social care services, in particular, to increase the number of care packages councils delivered each year.
Labour ‘committed to Dilnot’
Quizzed on the issue at the spring seminar, Gwynne said: “We have said that we are committed to Dilnot and we would seek to introduce those reforms. I have to have a discussion with Wes Streeting [the shadow health secretary] about how we facilitate that.
“I’d be very interested to know how the government, were it still in government then, would proceed with Dilnot and what resources it would make available for this.”
However, in an interview with Community Care, incoming ADASS president Melanie Williams said she was “not optimistic” that the reforms would go ahead, whichever party was in power after the election.
“I can’t see it happening because of the price tag,” she said.
Labour has not set out how it would fund the policy and it is hard to see how it would find the money within the constraints of the tight fiscal policy set by shadow chancellor Rachel Reeves.
Speaking more generally about social care funding, Gwinne said he needed sector leaders to help him “make the case to Rachel Reeves…that we need sound investment in care services, that helping people to live better lives is good for UK plc”.
Creating a ‘national care service’
In his speech, Gwinne also said that Labour would bring in a “national care service” within 10 years.
Gwinne said this would involve central government providing a “stronger national framework” for adult social care than currently existed, though responsibility for local services would remain with councils.
One example of increased central direction, he suggested, was placing stronger requirements on providers registering with the Care Quality Commission in relation to financial strength, worker terms and conditions and quality of care.
However, he did not flesh out what a national care service would entail, when asked to do so in a question and answer session in the speech,
Welsh and Scottish plans for national services
The Labour pledge comes with the Welsh and Scottish governments both planning to create their own national care services.
The Scottish Government is currently legislating, through the National Care Service (Scotland) Bill, to enable ministers to transfer social care responsibilities from councils to a new national care service (NCS) or regional boards set up to deliver functions on the NCS’s behalf.
This would apply to adult social care only in the first instance, and would be designed to tackle ‘postcode lotteries’ in the delivery and quality of services.
In Wales, the government has embarked on a 10-year programme to create its own national care and support service, covering both children’s and adults’ services, and providing care free at the point of need.
As a first step, it has set up a National Office for Care and Support, a team within the Welsh Government designed to provide stronger national direction on social care and develop the national care and support service.
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