Title

The new adult social care Green Paper has been welcomed as a move towards a much-needed debate on the social service system. But what does it mean for councils? Petra Barnby reports. Some people have criticised the Government for publishing its new adult social care Green Paper less than 12 months before a general election, with many concerned that it will mean a lack of urgency in changing what is widely-considered to be a deeply-unfair system. But, we are where we are, and the UK must now ensure the debate starts in earnest – and we have until 13 November to thrash it out. The first key issue for councils is how the Government proposes to sort out the funding crisis. The second is how ministers plan to sort out the postcode lottery, which sees people get a different quality of care according to where they live. It is worth noting that the funding proposals only relate to the cost for care – not accommodation – which can be ‘as much again', as the report points out. It explains: ‘This is because the state would not pay for people to buy their food or pay their mortgage or their rent, if they were living at home.' Despite this limitation, the three funding proposals put forward in the Green Paper have been broadly welcomed, not least because they will focus minds on a difficult problem. A senior fellow in social care at the King's Fund, Richard Humphries, thinks the devil will be in the detail. He says: ‘The underlying principle of all three options is that funding is a shared responsibility between the individual and the state. ‘This is a sensible platform for debate, but the costings need to be clearer, and more attention paid to what happens to working-age adults.' He adds: ‘The bottom line is that as a society, we need to find substantial extra money to pay for care and support in the future. Who pays, how much, when and how represent really hard choices, but choices that can't be fudged.' So, what are the options, and what would they mean for councils? They include: * partnership. In this system, people would get one-quarter or one-third of their basic care and support costs paid for by the state. Those who could afford it would pay for a higher proportion of their need, while the least well-off would get all their care for free. This means people would need to find, on average ,£20,000 * insurance. This is the same as the partnership approach, with the addition that people would be invited to enrol in a state-backed insurance scheme – either run by the state or private insurers – to ensure the remainder of their care costs were covered. People would need to pay in £20,000 to £25,000 into this scheme * comprehensive. All people aged over 65 would be compulsorily enrolled in a state insurance scheme. This could reduce premiums to £17,000 to £20,000, but people would need to pay, regardless of whether they needed care or not. The other area addressed in the paper that will interest councils is the idea of having a national, standardised system – a National Care Service – which will mean people will get the same proportion of cash, according to their needs, across the country. The Local Government Association has criticised the idea, warning that this would mean a ‘radical' change to council funding streams, and create another unfair system because care costs vary around the country. There are also concerns a national system could scupper plans for personalisation. But Mr Humphries urged council leaders to allow the debate to be held, without jumping to too many conclusions, too soon. ‘It could have profound consequences for local government, with a positive role – albeit a more strategic one – for councils,' he says. ‘It raises many questions about the balance of responsibilities between central and local government, including finance and accountability. ‘It will be important for options to be explored and developed during the consultation period, without reaching defensive positions too early in the debate. ‘Getting the right balance between national consistency and local flexibility is an ongoing challenge.' The real risk now is that the difficult nature of the issue, for which there are no easy answers, could allow it to be swept under the carpet. Mr Humphries says: ‘I think there is a danger about people reaching conclusions too quickly too early in the consultation process. ‘People need to reflect on things. What we need to do is work hard to keep the subject on the agenda, otherwise there is a real danger it could get kicked into the long grass.'

Title

More questions than answers

SUBSCRIBE TO CONTINUE READING