Funding concerns remain as adult care white paper published

The Government has today published its long-awaited Care and Support White Paper as well as a draft Care and Support Bill that will consolidate adult care laws into a single stature.

The Department of Health claimed ministers had accepted the principles of the Dilnot model – financial protection through capped costs and an extended means-test – for social funding.

The Government’s intention was to base a new funding model on the principles “if a way to pay for it can be found”, the Department said.

“However, whilst it is the right thing to do, given the size of the structural deficit and the economic situation the country faces, the Government is unable to commit to introducing a new system at this stage," it added. 

The Department said funding reform needed to be considered alongside other priorities and the right place to do this was at the next Spending Review. “A final decision will be taken then,” it insisted.

Among the options being considered is a cap of £75,000 on lifetime care costs, rather than the £35,000 suggested by Dilnot.

The Government has also committed to introducing a ‘Universal Deferred Payments’ scheme “to ensure no one will be forced to sell their home to pay for care in their lifetime”.

In other announcements, there will be a national minimum eligibility threshold “to ensure greater national consistency in access to care and support, and ensuring that no-one’s care is interrupted if they move”.

Councils will also be given powers to delegate assessment to third parties, although the authority will still hold relevant statutory duties.

The practice of ‘contracting by the minute’, which the Department of Health said could undermine dignity and choice for those who use care and support, will meanwhile be ruled out.

There will also be a new code of conduct and minimum training standards for care workers, and a Chief Social Worker will be appointed by the end of this year.

Other key actions set out by the Government today include:

  • Legislation to give people an entitlement to a personal budget.
  • The transfer of £300m from the NHS to social care “to support the transformation of local services and promote better integrated care for patients and service users”.
  • Implementation of schemes such as social impact bonds.
  • The establishment of a new capital fund, to be worth £200m over five years, to support the development of specialised housing for older and disabled people.
  • A new national information website and the investment of £32.5million in local online services.
  • Extension of the right to an assessment to more carers, and the introduction of a clear entitlement to support to help them maintain their own health and wellbeing.
  • Consultation on further steps to ensure service continuity for people using care and support in cases where a provider goes out of business.
  • Training more care workers. The government said it wanted to double the number of care apprenticeships to 100,000 by 2017.
  • Development, in a small number of areas, of the use of direct payments for people who have chosen to live in residential care, “to test the costs and benefits”.
  • Investment of a further £100m in 2013/14 and £200 million in 2014/15 in joint funding between the NHS and social care to support better integrated care and support.

The Department of Health claimed the White Paper set out how the social care system would be transformed “from a service that reacts to crises to one that focuses on prevention and is built around the needs and goals of people”.

Health Secretary Andrew Lansley said: “Our plans will bring the most comprehensive overhaul of social care since 1948 and will mean that people get the care and support that they need to be safe and to live well so they don’t reach a crisis point.”

Commenting ahead of Lansley’s announcements, the Local Government Association warned that without funding the White Paper would not go far enough.

LGA Chairman Sir Merrick Cockell said: “There is an immediate crisis in social care which needs to be urgently addressed now….No one would disagree that care should focus on an individual’s needs, but attempts to improve the quality of care are meaningless if there is no money for councils to provide these services.”

Sir Merrick called for a “concrete timescale” setting out when reforms would be made and providing a clear indication of where the funding would come from.

He suggested that the surplus £1.6bn from the NHS budget last year could be better spent on preventative services that help the elderly and the disabled live independently at home for longer.

The LGA recently warned that the increased cost of adult care could force councils to cut back or even halt together services that were popular with the public. It also said a fundamental change in the statutory duties placed on councils might be needed.

The Draft Care and Support Bill will consolidate more than a dozen Acts of Parliament dating back over 60 years. 

The Department of Health said people would be able to comment on the Draft Bill online, “making it one of the most open and transparent pieces of draft legislation ever published”.

Commenting on the draft Bill, Law Commissioner Frances Patterson said: “If implemented, this Bill will clarify the legal framework that supports adult social care and bring beneficial changes to many. With the demographic changes occurring in society that is a significant step forward.”

Full details of the White Paper, the draft Bill and other papers can be found on the Department of Health website

Philip Hoult