Social Care and the Spring Budget 2017: what the Government must do

In this new briefing Age UK explains what it thinks Government should do to save social care for older people now and put it onto a sustainable track for the future.

The briefing draws on the facts and figures in Age UK's The State of Health and Care of Older People 2017, published earlier this year, to set out ten principles it says should underpin the Government's approach towards social care for older people, and against which it will judge what the Chancellor announces in the Spring Budget on Wednesday 8th March.

The principles are:

• The need for a twin track approach that injects emergency funds now to prevent the system from collapsing and which buys enough time for a longer term review
• Government must take responsibility for running a longer term review but users, professionals and others must inform it and the public needs to be engaged in discussions about expectations, delivery and funding
• Fixing all the problems will take 5+ years so a cross-party approach is an option but what really matters is that politicians on all sides behave responsibly and put older people's interests above their own
• Supporting older people to be independent at home for as long as possible should be central to the thinking of any longer term review
• It ought to be made easier for older people to access care because it is cost effective but we do need to get rid of the postcode lottery we have now
• Older people with dementia and their families need more help from a reformed system of social care
• Talking about the role of families is fine but we have to be realistic about the practicalities and the truth is that when people give up work to care they usually get a pretty raw financial deal from the State in return, plus we need to do more to support the hundreds of thousands of older people who themselves care for loved ones
• Integration within health and between health and social care is the right approach and any proposals for the reform of social care must reinforce it
• Housing policy could be doing more to support social care and any review of social care should make this happen
• Workforce planning is really important for the future of social care and migration policy must be taken into account too

The document also sets out some considerations to be taken into account when it comes to paying for a better system of social care. These include:

• We all have a role in paying for social care because any of us may need it
• Whether we will in fact do so though is unpredictable and too horrible for most of us to think about, so that's why so few of us wish to save earlier in life for a care need that may never come - even if we can afford to and many can't
• Age UK favours a funding approach that minimises the stress on older people at the time they develop care needs - life it hard enough then without adding to it with financial worries
• We need to remember just how much most older people are already paying for social care - and families often too; for example, if they have to ‘top up' care home fees in situations when their loved one is supposed to get it for free
• Plus, older people who pay for their own care home place are estimated to be paying c.£4,800 more a year on average as a cross-subsidy to the State - a very considerable stealth tax made necessary because when the State funds a person's care it doesn't pay the true cost
• The NHS Continuing HealthCare regime that pays for social care in very restricted circumstances needs overhauling so the process is fairer and less complex for older people and their families
• There are big differences in income and wealth in our older population and across our society which need to be factored in, and the facts show that many older people aren't nearly as well off as some commentators would have us believe
• Incentivising older people to pay for care by dipping into their private pension pots is not an easy or cost free solution and in any case large numbers of older people either have very little private pension wealth or none at all, especially if they are women

Caroline Abrahams, Charity Director at Age UK said:

"At Age UK we are hoping and praying that on Wednesday the Chancellor will announce an emergency funding package to prevent social care from collapsing this year and next, and his intention to use the time that investment buys to come up with a long term solution.

"Successive governments have ducked the challenge of putting social care onto a sustainable financial footing but now the evidence is all around us that the task can't be put off any longer, or we risk whole districts becoming ‘care deserts' in which it is all but impossible for older people to find the care they need. If the Government has now recognised this they deserve our support.

"Social care is a fundamental public service which when delivered well can make a huge difference to older people's health and quality of life, diverting some demand away from our hospitals. For these reasons we ought to be making it straightforward for older people to access social care when they need it.

"Older people who themselves are caring for loved ones, often a husband or wife, and older people with dementia and their families, are overlapping groups that we believe need more help from a reformed social care system than they typically receive now.

"Meanwhile, on the policy side, housing policy ought to be much more closely aligned with social care policy than it is today, and workforce considerations mean that's true of migration policy too and that potential Brexit consequences need factoring into the mix."

"Coming up with a sustainable funding solution for social care will be difficult but not impossible we think, given the sums involved. There are lots of options for any review to consider but certainly at Age UK we think we should all have a role in paying for better social care and on a broadly progressive basis, as it is a fundamental public service that we may all need to use one day. Paying for social care has traditionally been a partnership between the individual and the State and that should continue; this principle could be given expression in many different ways, including by the State standing behind a system that allows us all to share the risk of developing significant care needs."

"We also believe we should seek a funding approach which minimises the stress and uncertainty for older people when they actually develop care needs. Policy debates about social care often fail to take into account the upset and sadness associated with this stage in an older person's life, and of course their close family's too if they have one. The last thing anyone needs is money worries at such a difficult time."