Last year, just before the Care Act came into force, I took part in a BBC broadcast explaining its effect. I told viewers that one of the most important and positive changes was a cap on the cost of care, which the government would introduce in April 2016. What I didn’t know was that a few months later, the government would announce that this reform would be kicked into the long-grass.
If all had gone to plan, self-funders – who frequently get the worst deal paying for quality care – would now be able to start a care account with their local council. They could add up what they were spending on essential care costs, so that when they reached the £72,000 cap, the state would step in to pay.
According to the government’s 2015 impact assessment, the reforms would have offered protection and peace of mind to the estimated 16% of older people who will have lifetime care costs exceeding £72,000. A total of 37,000 people would have reached the cap by 2020. An estimated 23,000 people would have benefited in the first year alone as a result of lower thresholds for state support. It would also have brought many self-funders into contact with their local authority for the first time, making them aware of their right to a care assessment and information and advice.
The government said the decision to postpone the cap until at least 2020 reflected fears that local councils, already under huge financial pressure, would not be able to cope with the increased demand. It also said the benefit of the cap was hard to explain to the public and didn’t justify the extra cost to the Treasury.
But when it first proposed a care cap, the government said it would protect older people from “catastrophic care costs” and “end the unfairness and fear caused by unlimited care costs”. This was needed because “there is currently no safety net to protect people from losing almost everything”.
With the postponement of the cap, older people and their families are again left without a safety net against catastrophic care costs.
One person in this position is Clare, who answered our recent survey on experiences of the Care Act: “I have a long term condition with a lot of complications, so need a lot of support and one-to-one care. I have been paying for some care, my husband does most of it and I use Access to Work to pay for support in the day while I’m working, which costs about £1500 a month.
“However I’m soon to retire at 70, which means losing these Access to Work payments. I will be entirely dependent on using my savings. I had been hopeful of the opportunity of using the cap in the care act legislation so it would take me three years to spend £72,000 and I would then be eligible for financial assistance from the local authority. However, now I have no choice but use my savings until they are all gone.”
Critics of the cap argued that it was complicated, hard to explain and that didn’t cover all the costs associated with residential care, such as food and lodging. But it was a measure that began to address the huge inequalities faced by self-funders. And it was, quite frankly, something rather than nothing.
To illustrate the point, in its 2015 impact paper the government gave the example of someone aged 65 who has assets of between £100,000 and £150,000 (including the value of their home) and spent eight years in a care home. They could expect to spend around 80% of their assets paying for care, most of what they had worked and saved for their entire lives.
More and more of us are living for longer. While that’s good news, it does mean more people will be living with complex – and expensive – care needs. This issue is only going to get more pressing; it can’t be ignored.
When the government announced the delay,it said it was still “firmly committed to delivering this historic change” but that the time was not right to add £6bn to public sector spending. That will be little comfort to older people who face losing nearly everything, and it is perhaps understandable if we are sceptical that this “firm commitment” won’t be quietly dropped come 2020.
We know council budgets are under huge pressure. Social care budgets have been reduced by £4.6bn since 2009-2010. But the issue of who pays for care in later life cannot be ignored. That’s why we want an independent commission to look at the future of health and social care, so people can plan for their old age with some certainty.
Janet Morrison is chief executive of Independent Age
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