Consulting on the future of care
Reza Motazedi describes the government's thoughts and options on social care on which it has launched a consultative process.
The government has launched its Green Paper on the future of the care and support system in England
The paper is "Sharing the Future of Care Together" and has been launched after extensive consultation with representative members/associations and charity and other not for profit organisations.
The plans will affect the sector, both providers of support and recipients, in a major way. It is effectively an expansion of the welfare state.
The government has called for a major debate on the issues mentioned in the Green Paper and the window for taking part is closing in November.
The Green paper is a response to the ideas first mentioned in "Building Britain's Future" the proposal is to build a new National Care Service for everyone.
During 2008 a 6 month process of consultation took place and the Green paper is effectively the government response to the issues and concerns raised by the service users and the service providers.
The paper addresses the issue of care and support for a range of reasons, which include care required as a result of accidents, long term illness, disabilities and getting older.
As such, it aims to provide a comprehensive solution to the provision of care.
The reason for the Green Paper is that the existing system of social care is not a single one (unlike the NHS), but the result of many series of developments over many years.
Another major reason to prompt the government has been the general increase in life expectancy of the population.
It is estimated that by 2026, 1.7 million adults will require care and support, in one way or another, through old age.
The aspiration is to build a stronger, fairer Britain by implementing a National Care Service. The system is promised to be fair, simple and affordable for everyone.
Whether or not this turns out to be the case is of course to be judged in the years to come.
Because of the emphasis on its national role, the system promises that everyone should be able to get really good care wherever they live and whatever their needs.
This is something which forms the principle behind the NHS but the delivery is debatable and subject to much publicity from time to time.
The government believes that everyone in the country should expect six major entitlements under the system:
- The right support to help you remain independent and well for as long as possible and to prevent your care and support needs from getting worse.
- Wherever you are in England, the right to have your support and care needs assessed in a consistent way.
- All the services to work together smoothly, especially when the needs of the recipients are being assessed.
- To be able to understand and find your way through the system easily.
- For services to be based on your personal circumstances and needs.
- For your money to be spent wisely and for everyone to have access to some help with the cost of care and support.
In order to assess the public's view about these six areas, the consultation question is asked to ensure that the list is both comprehensive and workable.
The government acknowledges that the provision of the service should be joined up, but wants users and providers to comment on how the joining up is going to look in practice and also explore the barriers to integration.
The Green Paper then goes on to consider five ways in which the National Care Service could be funded:
- Pay for yourself - under this option, there will be no support from the state even for people with the lowest incomes and no savings - this option is ruled out.
- Partnership - everyone who qualifies would be entitled to a set proportion (20% or 30%) of their care paid for by the state; the rest is paid for personally.
- Insurance - same as 2 above, but the additional cost of care would be provided by insurance - different ways as to how this insurance is paid for is then explained in the Green Paper.
- Comprehensive - everyone over retirement age, who could afford to do so, would be required to pay into a state insurance scheme.
- Tax funded - the basic care is provided free under this system and the system is funded by people paying tax throughout their lives, which would be used to pay for all the people who currently need care.
The Green Paper seeks views on which of the above systems of 'Partnership', insurance' and 'Comprehensive' is preferred.
The Green Paper is a major development in the care system and it will be interesting to watch its development over the next phase of the consultation.