The care funding solution must be fair; simple and sustainable
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Any solution for funding better care for older people must pass three tests, says national charity, Counsel and Care. It must be ‘fair, simple and sustainable’.
With a White Paper on the funding of a national care service expected shortly, Stephen Burke, Chief Executive of Counsel and Care, said: “There is consensus that the care system must be radically reformed, and there is consensus that care is significantly underfunded. Older people needing care now and in the future ageing population deserve better. The Government estimates a £6 billion funding gap and if we are to deliver better care then more will be needed.”
- There is no question that a new care system must make better use of existing resources and provide better support for older people and family carers to help themselves. But we also need to fund care better.
- There are no easy choices – we will all have to pay more for care in the future.
- Any future funding solution must pass at least three tests: it must be fair, simple and sustainable. Fair so it relates to people’s ability to pay and wealth. Simple so that it is clear what you pay and what you get. And sustainable so it will continue to pay for better care as our population ages.
- The big question is how we pay for better care and this is where agreement breaks down.
- The debate is often characterised as a split between those in favour of voluntary contributions against those supporting compulsory payments. I think it would be more accurate to express it as a choice between individuals paying their own way on the one hand versus a collective approach sharing the risks and costs of care on the other.
- The recent care conference convened by the Secretary of State for Health suggested a consensus around the comprehensive option in last year’s green paper – whereby people would get the care they need, free at the point of delivery, in return for a one-off payment. The question is how much would people be asked to pay and when.
- One suggestion of £20,000 from estates has been labeled as ‘a death tax’. It would be the care equivalent of the poll tax. Clearly everyone being asked to pay the same lump sum is unfair and a non-starter.
- But there are a number of other ways in which payment for the comprehensive option could be made. One alternative would be a care duty on estates – a small percentage, say 2.5% on all estates above £25,000.
- A care duty would be fairer because payment would be related to people’s wealth; we already have a collection mechanism in place; it would keep pace with our ageing population and increase as wealth increases; and there is logic in linking a payment at the end of life with what is mainly end of life care. Simplifying payment and making care free at the point of delivery would help make better use of existing resources by reducing transaction costs and by making it easier to join up social care with health care.
- I believe a care duty would be a fair, simple and sustainable way to pay for better care.
- Posted in: Health Care, Healthcare
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