“Shaping the Future of Care Together”
In July 2009 the Government produced their Social Care Green paper “Shaping the Future of Social Care Together” setting out their proposals for ways to reform the care and support system for adults in England. The basic proposal is to build a National Care Service that is fair, simple and affordable.
Within the new system the Government puts forward six things that one should be able to expect from a National Care Service:
- Prevention services: the right support to help people stay independent and well for as long as possible and to stop their care and support needs getting worse.
- National Assessment: wherever a person is in England they should have the right to have their care needs assessed in the same way and the right to have the same proportion of care and support costs paid for.
- A Joined-up Service: all the services that a person needs should work together smoothly, particularly when needs are assessed.
- Information and Advice: People should find it easy to get information about who can help, what care to expect and how quickly it can be put in place.
- Personalised Care and Support: Services should be based on personal needs and circumstances.
- Fair Funding: Money will be spent wisely and everyone who qualifies for care and support from the state will get some help meeting the cost of care and support needs.
The paper lays out five funding options:
- Pay for Yourself - Everybody would be responsible for paying for their own basic care and support when they need it. This has been ruled out as it would leave many people without the care and support they need and is seen as fundamentally unfair because people can not predict what care and support they will need.
- Partnership - Everyone who qualified for care and support from the state would be entitled to have a set proportion of basic care and support paid for by the state. The less well-off would have more care and support paid for, whilst the least well-off would get care and support for free.
- Insurance - As with the Partnership model everyone would be entitled to have a share of their care and support costs met. But with this system people would be helped to cover the additional costs of their care and support through an insurance system, if they wanted to. The insurance scheme could be state run or provided through the private insurance market. Options could also exist over how and when people pay into the insurance scheme, before or after retirement or after death if they preferred. Once people had paid their contribution into the scheme they would get their care and support for free when they needed it.
- Comprehensive - Everyone over retirement age who had the resources would be required to pay into a state insurance scheme. Everyone who was able to pay would pay according to their means and then everyone whose needs meant they qualified for care and support from the state would get their basic needs met for free. A system of free care and support for working age people would be looked at to run along side this.
- Tax-funded - Tax paid throughout a persons life would be used to pay for all the people who currently need care. This is ruled out because it places a heavy burden on people of working age.
The Government believe that a partnership model has to be the foundation of the new system and to protect people against the risk of potentially high costs for care and support either the voluntary insurance scheme or the comprehensive scheme. It is acknowledged that this would be a significant reform and so it is anticipated that a new National Care Service would be phased in over a number of years.
Making the best use of current funding sources is also considered in the paper. With a case being made for drawing what the Government sees as current care and support funding streams together. This includes a proposal to integrate some elements of disability benefits like Attendance Allowance into the care and support system.
Further questions over whether in a new system local or national government should decide on the level of support and funding provided are also open for consideration.
Currently this Green Paper is in consultation stage, a White Paper on care and support is expected to be published in October 2010. For further information and to join in “the big care debate” go to http://careandsupport.direct.gov.uk