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Shaping the Future of Care Together

This Green Paper on the reform of adult social care in England was published 14 July 2009. It examines proposals to set up a National Care Service, a care equivalent of the National Health Service.

The closing date for responses to the green paper was 13 November 2009.

You can view our response to the green paper from the links below.

Background

The paper proposes that such a system should apply across England and should be:

Following on from this the paper discusses what people should expect from such a system, how the system would work and how it should be funded.

Expectations

The paper identifies 6 elements that people should expect from a National Care Service:

How the system should work

The paper emphasises joined up working between various national and local government strands, such as those providing benefits, care, health and housing. The aim is that a wider range of services be made available backed by a system better able to identify needs and ensure they are met.

Funding

In the current system, people who have the highest needs and lowest means get some help through the social care system, and some people get help through disability benefits. But many people, including some with high needs, get no help with paying for care at all.

The intention is that everyone will get fully funded help to meet between a quarter and third of their care needs. Those on low incomes would get more financial support. Everyone else would have to pay towards their care.

It is proposed that this could be funded in one of three ways:

  1. Partnership - People who needed high levels of care and support would need to spend their savings and sell their homes.
  2. Insurance - Additional costs met through voluntary insurance. This scheme would help people to protect their wealth and the value of their homes.
  3. Comprehensive - Everyone over retirement age who had the resources to do so would be required to pay into a state insurance scheme. All basic care and support would be free when it was needed. The Government would also look at having a free care and support system for people of working age alongside this.

Note: The term care and support does not refer to the accommodation costs incurred as part of a residential care package.

"As well as care and support costs, people entering residential care have to also pay for their accommodation costs, for example food and lodging. Although there will always be a role for the state to play in helping people with low income and assets, we believe it is fair to expect the majority of people to meet these costs themselves.

However, we also think there is more that the Government can do to help people with the way they pay these costs. We are proposing a universal deferred payment mechanism, allowing residential care and accommodation costs to be charged upon a person's estate when they die, rather than having to go through the process of selling their home when they need residential care."

Attendance allowance

Page 102 of the Green paper examines the role of disability living allowance and attendance allowance in relation to social care. It is considered that there are inconsistencies of approach between disability benefits and social care within the current system because the two systems developed in isolation from each other and are allocated on different bases.

"We think we should consider integrating some elements of disability benefits, for example Attendance Allowance, to create a new offer for individuals with care needs. If we decide that integrating some disability benefits, such as Attendance Allowance, into a simplified system is the right approach, we would want to ensure that the future social care system retains and builds on the main advantages of the current disability benefits system."

Note: Currently attendance allowance ceases after 4 weeks when someone enters residential care. It can also be used to help pay for any care services in the home under Fairer Charging Policies for Home Care and other non-residential Social Services.

Disability Alliance's response

You can view our response to the green paper from the links below.

Summary of responses

A summary of responses has been published on the Department of Health website, available from the link below.

What next?

The Government has now published a White Paper on care and support with detailed proposals for implementing a new National Care Service offering care and support for everyone.

The White Paper, building the national care service is available from the link below.

More information

  1. shaping the future of care together - link to green paper on Department of Health website
  2. careandsupport.direct.gov.uk - link to online video, green paper and easy read version
  3. fears about the loss of dla as part of social care reform - Disability Now interview with care services minister Phil Hope
  4. scottish mps oppose abolition of attendance allowance
  1. disability alliance
  2. coalition on charging
  3. disability benefits consortium
  4. summary of responses - DH website
  1. funding social care: what service users say - Joseph Rowntree Foundation report. Posted 10 March 2010.
  2. mps debate the future of attendance allowance - Posted 15 December 2009.
  3. social care green paper debate - Commons Hansard 29 October 2009
  4. government considering dla as part of care reform - Lords Hansard 13 October 2009
  5. identifying a fairer system for funding adult social care - This Joseph Rowntree report examines the Social Care Green paper.
  6. independence, well-being & choice: our vision for the future of social care for adults in england -
    Green paper sets out a vision for adult social care over the next 10 to 15 years published March 2005
  7. pay £8000 and keep your home if you go into care - Conservative party proposals
  8. personal care in scotland - Audit Scotland report
  9. the case for change: why england needs a new care and support system - This report discusses why the social care system needs reform and set the stage for a nationwide discussion.
  10. securing good care for older people - Wanless Review (the King's Fund website)
  11. the future of care funding: time for a change - report, produced by the Caring Choices
  12. the case for social care reform: the wider economic and social benefits - This report was produced by the University of Birmingham 's Health Services Management Centre. It concludes that without a radical rethink of current priorities the real cost of providing social care will double in the next twenty years.

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