As Labour prepares to release a White Paper on the new structure of social care in England, the government is coming under fire for its Personal Care at Home bill, which will form part of the new National Care Service. The bill, which promises to provide free home care for people aged over 65 and who have ‘critical’ care needs, is seen as flying in the face of July’s Green Paper, in which the government ruled out taxpayer-funded free care. Labour’s change of heart over free care was initially welcomed – if cautiously – by charitable organisations in particular. However, it has become clear that funding for the new system is unsustainable given the various factors of the recession, far-reaching public spending cuts and a gross underestimation of the amount of free care that will be required. Increasingly, the promise of free care is being seen by the media as a pre-election gimmick to secure votes in the run-up to the general election, with the Guardian commenting that: ‘…with barely 100 days before the election, the claim to have rolled back the hated means test no doubt seems attractive.’ Despite voting in favour of the Personal Care at Home bill, the other main political parties are proving to be more cautious than Labour when outlining their own plans for funding social care. The Conservatives seem to favour an insurance-based system whilst the Liberal Democrats have scrapped their original plans to provide free care, indicating that to do this would be economically unsustainable – a view shared by a number of organisations including the Association of Directors of Social Services (ADSS).
Experts have warned that the current government figures for free care fail to take into account either an increase in demand with time, or the effect of people who previously chose to pay for private care switching to free care because they now qualify for it (a situation described by the Guardian as ‘redistributing to the rich’). Whilst challenging the Personal Care at Home bill in the House of Lords, former health minister Lord Warner warned that when Scotland began offering free personal care in 2003, the costs doubled within four years and the number of claimants went up by 36%. Although the bill survived the challenge, more and more organisations are now backing the view originally put forward in the Green Paper that individuals must share the cost of care with government funding.
Other concerns around the Personal Care at Home bill centre around how it will be decided which people have ‘critical’ care needs and will therefore receive funding. How will needs be assessed as ‘critical’ and what help will be available for those whose needs are severe, but not ‘critical’? This is made more complex by the fact that currently, local authorities all interpret care needs differently. Some authorities currently classify ‘critical’ care needs together with the lower category of ‘substantial’. With councils also offering different care services at different prices, there is a risk that many people will miss out on funding due to a ‘postcode lottery’ – as was the case when continuing care eligibility criteria were first introduced in 1995.
