Social care levy tinkers around edges of broken system

Think-tank Nuffield Trust has condemned the Government’s health and care levy as “tinkering around the edges of ‘broken’ social care.

The think-tank describes the funding package announced in early September as a plan that “falls short of the comprehensive reform that social care so badly needs.”

It adds: “Social care suffers from deep structural issues that cannot be fixed by money alone. These proposals simply tinker around the edges of the existing broken system and offer little guarantee that more people will be able to access care.”

In the package, social care will receive £5.4 billion of the anticipated £36 billion, spread across three years. It is hoped that a white paper – promised “later this year” – will add more detail to plans that centre on a pricing cap and floor, some workforce support, and changes to provider fees.

In detail, these elements are:

Cost cap: The cap on care costs is set at £86,000 to take effect in October 2023, excluding “hotel” costs (bed and board) in residential care. “Personal care” costs covered by the cap will cover a narrow set of services centred on the basics of existing: dressing, washing, eating, using the toilet, moving from bed to chair. The trust says: “The government’s primary intention to stop people selling their homes may not be realistic for many.

Raised floor: The lesser-known, but arguably more significant, support act to the cap is the “floor” – the level of savings and assets an individual can hold on to and still be eligible for council-funded care. The current £23,250 level has been raised to £100,000: below this level tapered funding will be available down to £20,000. The existing requirement for people with means below £20,000 to contribute from their income remains. 

Workforce support and provider fees: The defined allocation is £500 million for workforce development. However, this is said to do “nothing to address the immediate issues of low pay and poor contractual conditions which, along with the impact of mandatory vaccines, Brexit, and new immigration rules” which have left posts unfilled.

Nuffield suggests that the government has missed an opportunity to build a fairer, more sustainable, and better social care system that seeks to improve people’s lives. It says: “The sums promised so far look modest in light of what they are intended to deliver.”

 It warns that the effectiveness of these changes largely depend on councils having enough money to fund higher fees that will now additionally have to absorb the increased NI costs. The document states that councils will be required to shoulder additional costs through “appropriate local level mitigations”. Nuffield concludes: “Cuts to budgets, along with COVID-19, have left council finances in a precarious state and many will struggle to raise extra money from local sources.”

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