Monday, 21 February 2022

The "catastrophic costs" of the new social care funding regime

 If anything shows where the current government’s priorities really lie, it’s the way social care funding is being reformed.  As Baroness Jane Campbell said in a recent House of Lords debate “protecting accumulated wealth has become the overriding goal of reform”.  

For years the ‘problem’ of social care has been framed to be the ‘catastrophic care costs’ faced by some older people who, if they need to enter residential or nursing care, have to sell their homes to pay for it, thus reducing their children’s inheritance. But the catastrophe for many working age disabled people takes the form of years of poverty and a denial of opportunities.  Moreover, a recent amendment to legislation currently going through Parliament will embed such poverty as an integral part of the new funding regime for adult social care.

This new regime, which will be introduced from October 2023, will place a ‘cap’ of £86,000 on what someone will have to pay towards their care. It is being funded by increasing the National Insurance contributions paid by people of working age and therefore disproportionately affecting those on low incomes.  

This is unjust in itself but the government is now attempting to introduce an amendment which would change the way the cap works so that the wealthier you are the more you benefit.

Unlike health care, social care is means-tested and in recent years local authorities have been increasing the amount that people have to pay towards the cost of necessary care. For those who rely solely on benefits, this means anything above a Minimum Income Guarantee has to be used to pay for their support

Initially, the proposed new funding regime assumed that the amount local authorities contribute towards someone’s care would count towards the cap of £86,000.  Now, the government intends that only the amount someone contributes themselves should go towards the cap. A real life example, provided by Inclusion London, illustrates the unfairness of this for those who enter adulthood already disabled.

“A disabled person like Nadia, without assets and minimal chances to enter the labour market and accumulate wealth, must pay for care from means-tested benefits. The Government sets minimum amounts of money people should be left with. These vary depending on age, personal circumstances, and the impairment's severity, starting from £72.40 per week.  

Young adults such as Nadia with high support needs are left with £151.45 per week to live on. With her contribution of £68 per week, Nadia and people in a comparable situation will have to live on as little as £151 per week for 24 years. Only after that would they qualify for free care and be able to keep all of their disability benefits.”

This situation would also apply to anyone who becomes disabled during adulthood.  For example, consider you are a 29 year old, progressing well in your career, still living with your parents but slowly building up savings in the hope that you’ll be able to afford your own home. But one day, out of the blue, you are involved in a car accident which leaves you paralysed.  Once you come out of hospital you find that your job is no longer possible so your only income is disability benefits - which are diminished by the contribution you have to make towards your care costs.   You will be now be condemned to years and years of living in poverty.  And your chances of ever getting a home of your own have disappeared. 

The 2011 Dilnot Commission recommended that : “All those who enter adulthood with a care and support need should be eligible for free state support immediately rather than being subjected to a means test”. Andrew Dilnot repeated this recommendation in the context of the current legislation. But instead, the government has made the new regime even less fair by introducing the new amendment currently going through Parliament.

And it isn’t only people of working age who are getting a poor deal from this new system - whatever age you are, the fewer assets you have the more likely you are to lose almost all of them.  

As Torsten Bell, of the Resolution Foundation said: “Here’s a simple way to think about the problem the government has created: if you own a £1m house in the home counties, over 90% of your assets are protected. If you’ve got a terraced house in Hartlepool (worth £70k) you can lose almost everything”.

The two examples on the government’s own website illustrate how, the more you have in assets and income, the greater proportion of those assets and income you keep. 

The Dilnot Commission’s original proposals rejected the approach the government is taking as it goes against the purpose of a means test - ie ensuring that the fewer resources you have the smaller contribution you make towards your care costs.

So the only thing we can conclude from this is that the Conservative Party has decided that its priority is to protect the accumulated wealth of its core vote.

There are members of the House of Lords who are trying to defend the interests of those who have little or no accumulated wealth.  Their next chance to do this is at Report Stage of the Bill, which begins on 1st March.  We can only hope that they have more success than they have had so far.