Care Support Independence

Public engagement for the Care and Support Green Paper ended on a high note with a day of lively debate in Birmingham.

296 delegates, drawn from those who attended four previous events held around England, gathered to re-visit the issues and principles behind care and support reform and take the debate forward.
 
“We are here to have a really important discussion about the future,” said David Behan, Director General for Social Care, Local Government and Care Partnerships at the Department of Health. “We will listen to you today and build that into our further thinking.”

He put three main questions to delegates: How should the care and support system be paid for? What level of support should people get? How we manage the care and support system in the future?

Priming the discussion on funding, head of the Green Paper team Alexandra Norrish told delegates that the amount of money required for care and support works out at approximately £40,000 per person aged over 65 in England. 

“We need to work out how best to ensure there is enough money available to cover all the costs,” she said.

Mostly delegates felt that that the Government had a large part to play in providing care and support, but there were many different opinions as to how the future system should work.
 
As at previous events, there was a lot of support for using taxation to provide a basic level of care for all.

“All people should get the same regardless, if all have paid into the pot. It’s the only way to do it,” said one delegate. “If there was a set standard for care for all, and those who wanted to could pay extra to top up.”

However, there was some debate as to whether tax increases are a realistic option.

One delegate commented that “the Government are not just going to say ‘everyone must pay 1% extra tax’, they would lose votes”.

In reply, another said: “If they said ‘taxes are going up so people can get care’, I think people will accept that.”

Some challenged the whole tax idea by saying there should be a rebate for those who have not needed care and support: 

“If you don’t use what you’ve paid for you should get it back. You could then pass it on to your children or grandchildren,” was one opinion.

The most contentious issue was the option of using savings and housing assets to pay for care and support after death, as some people do under the current system.

The idea of capping the amount taken from an individual’s estate and using taxation to make up the shortfall was mooted, but this idea was not without its critics:
 
“Is it fair that somebody who has, say, a mansion should have part of their care and support paid for by somebody who will never have that level of wealth or comfort?”

At the other end of the scale, some delegates were completely against, as one put it, “the Government getting their hands on our houses.” 

The next section of the day focussed on how care and support should be organised. The results of a polling session indicated that delegates felt the need for a balance between flexibility at local level and consistency at national level.

“National consistency should come first,” said one delegate. “We should set a minimum standard so local authorities know what they should be doing. Then, like Ofsted, inspectors could go around and check that local work is in line with that standard.”

On funding, another added: “The money should be collected, owned and managed centrally. Local authorities would have to justify why they want the money.”

The final discussions of the day highlighted the importance of improving the lives of disabled people by helping them to gain access to education and employment. There was a strong feeling among delegates that tax should be used to provide care and support for disabled people.

“I’m really grateful that you have given us your support and insight,” said Care Minister Phil Hope. “As you have been working through the questions you have seen how difficult these issues are.

“This is a debate about the next twenty to thirty years. The new system will have to be robust enough to deal with economic ups and downs.

“I want us to have a vigorous debate. I hope to reach a consensus and create a fair system that will make us proud of the society we live in.” 

Looking ahead to the Green Paper and following consultation period, the Minister said: “It will show the different options and we will spell out the advantages and disadvantages. We will be interested to hear your reactions to them. You will get a second bite at the cherry.”