Annex 11: Changing how we pay for health
and social care? (see paragraphs 24 and 28 to 30 of the report)
192. There is a serious public funding gap in
social care in England, despite the fact that under current systems,
massive costs for social care can also fall on the individual.[278]
In response to the Dilnot Commission's report, the Government
are proposing to raise the asset limit at which people must pay
for all their care to around £123,000 in 2017/18 prices.[279]
The Government are also proposing that individuals should not
be called upon to pay more than £75,000 in 2017/18 prices
in reasonable care costs over their total time receiving care.
193. We consider that the Dilnot Commission's
proposals are far from a panacea for social care funding. The
Government have estimated that the costs of their proposals in
response to the Dilnot Commission will be £1 billion a year
by the end of the next Parliament (i.e. 2020).[280]
The major gainers will be the relatively better-off, who will
be protected from depleting their housing assets;[281]
and those who immediately gain will be the generation who have
benefited from increases in housing wealth on an unprecedented
scale over the past half-century (see Annex 7).
194. The main advantages of the Dilnot Commission
proposals were that they made clear to individuals the need to
plan for the likely costs of long-term care, put a limit on the
risks that individuals face, and would encourage the private insurance
and pensions sectors to enter this market. The Committee considers
that the Government's response to the Dilnot Commission proposals
is a welcome step in the right direction, and necessary, but it
will not be sufficient. The proposals are primarily concerned
with redistributing the costs of care. They do not bring extra
funding into the system to tackle the current funding crisis,
avert the tightening of eligibility criteria for care access,
or address the problem of expanding need in the coming decades—although
we acknowledge that this was not the task given to the Commission.
195. We have already argued (in Annex 7) that
those who have benefited most from the housing boom should make
a fair contribution to the rising costs of their own care. We
consider that enabling people to access the value locked up in
their homes through equity release will be crucial to helping
older people to fund the care costs they may face.
278 The Dilnot Commission estimated that while a quarter
of people aged 65 will need to spend very little on care over
the rest of their lives, half can expect care costs of up to £20,000,
and one in 10 can expect costs of over £100,000. Fairer
Care Funding - The Report of the Commission on Funding of Care
and Support, July 2011. Back
279
Adult care services provided by local authorities are funded partly
by central government, partly by revenue raised locally and partly
by fees charged to users. The age of an authority's population
and other factors affecting local need for services are taken
into account in determining the size of the central government
grant. People with savings and assets over £23,250 currently
pay in full for local care services (and those with assets in
a band lower than this threshold have to run down those assets
to help pay for care); someone receiving care in their own home
does not have their housing assets taken into account, but in
residential care they do unless a partner or dependent is living
in the relevant home; an assessment of the individual's income
will also determine what charges the local authority makes for
its services. Back
280
DoH, Policy statement on care and support funding reform and
legislative requirements, 11 February 2013. Back
281
Fairer Care Funding - The Report of the Commission on Funding
of Care and Support, figure 11, July 2011. Back
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