Social care provision should be modelled on the state pension, with taxpayers funding a flat-rate “universal care entitlement”, which citizens could supplement from their own funds.
That’s the view of former Conservative cabinet minister Damian Green MP – who is due to speak at Health+Care Conference on 26 June.
In a report published by the think tank the Centre for Policy Studies, Green argues that current social care provision is patchy and inadequate, and the government has to spend an additional £2.5bn on it each year to achieve sustainability.
It acknowledges that commissions and reports have come and gone, Select Committees have investigated and made recommendations, and yet we appear no closer to a political consensus on how to proceed.
Indeed, the social care green paper has been delayed five times since its original publication date of summer 2017.
The General Election of 2017 summed up the perils of grasping this particular nettle. A Conservative Party promise to allow people to keep £100,000 of assets whatever the costs of care was rapidly dubbed a “dementia tax”.
The Labour Party had a similarly bruising experience in 2010, when its own proposals were attacked as a “death tax”.
But the precarious situation that social care finds itself in is only going to get worse without a comprehensive overhaul of the existing system.
There are currently 5.3 million over-75s today, and that number is likely to double over the next 40 years.
Green argues that a funding boost would allow Whitehall to provide a universal, flat-rate entitlement, of perhaps £2,000 a month for residential care, or £2,500 a month for nursing care.
He suggests the funds could be paid directly by government to an approved care home chosen by the patient and their family, after a needs assessment by the local authority.
Green said social care had to be moved to a national level, rather than being the responsibility of councils.
Under the plans, some patients could also buy an insurance-style “care supplement”, to fund a higher standard of provision, perhaps by releasing part of the value of their property.
In order to fund more generous state provision, Green suggests taxing the winter fuel allowance and redirecting any savings made in the forthcoming spending review.
As a “last resort”, he says, the over-50s might be asked to pay a 1% national insurance surcharge, “in exchange for a guarantee that their personal finances will not be exhausted by the costs of social care, and that they will be looked after whatever their condition”.
Green said the proposals would “put social care on a solid footing in this country”, and would model the state pension system in being simple to grasp and fair.
However, Labour immediately seized on the proposal for a national insurance surcharge, with the shadow chancellor, John McDonnell, calling it “a tax on getting old”.
He said: “After nearly a decade of brutal cuts to social care, the Tories now want to make older people pay through increased taxes.
“We want to hear today a clear statement from the government that they will reject this call, protect the triple lock, and follow Labour’s call to fund social care properly.”
Green, however, said it was fair to ask older people to pay towards improving social care rather than all citizens.
“Given you have this huge raft of wealth, particularly in housing, £1.6 trillion that people have in housing wealth – a sliver of that, frankly, used for social care would buy peace of mind in your old age and would get more money in the social care system,” he told BBC Radio 4’s Today programme.
Given the demographics, he says “almost all local authority budgets, at the way we’re going, will be sucked into paying for social care, which won’t leave money for anything else”.
Part of the problem has been the Government’s austere approach to public finances. Last year, a joint report by the House of Commons Health and Local Government Select Committees estimated that in 2019-20, there will be a funding gap of £2.2 to £2.5 billion.
It estimates that 1.2 million of over-65s are missing out on the help they need.
While the Chancellor has resorted to “bail outs” of local authorities to relieve intense short-term pressures, a more sustainable approach is needed.
But the government has repeatedly delayed publishing its long-promised green paper on a new long-term funding model, fearing a backlash.
A close ally of the Prime Minister for many years, Green was sacked as first secretary of state in December 2017.
After the last election, Green, who was then work and pensions secretary, was initially meant to oversee the green paper, and this intervention will be of significant interest to the government.
He says four key principles must be met by any new system – including more money for social care; a fair system across generations, medical conditions, and for savers; a better supply of reasonably priced care options and retirement housing; and, public and cross-party consensus on the way forward.
Even if the Government disagrees with his proposals, it’s hard to argue with Green’s key principles.
- Damian Green MP will be joining Michael Voges, Executive Director of the Associated Retirement Community Operators (ARCO) & Chair of the Care Provider Alliance; Paul Burstow, Chair of the Social Care Institute for Excellence and former Care Services Minister; and, Anita Charlesworth, Director of Research and Economics at the Health Foundation, Honorary Professor in the College of Social Sciences at the University of Birmingham
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