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Where are we on long-term care reform?

The health secretary published its long-awaited care and support white paper last month alongside a progress report on funding.

Its initiatives are to:

  • establish a new national information website to provide a clear and reliable source of information on care and support;

  • support local authorities to develop online information about local care and support options;

  • introduce a national minimum eligibility threshold, bringing greater consistency in access to care and support across England;

  • ensure better integrated care and support between NHS and social care services; and

  • legislate to give people an entitlement to a personal budget as part of their care and support plan.

However, it is important to note the paper acknowledges this is a long-term plan for the reform of care and support that will happen “in stages over the next 10 years”.

Alongside the white paper was a progress report on how care is to be funded. Disappointingly, the report is largely empty on commitments. It is careful to state that: “The Government supports the principles of the approach recommended by the Dilnot Commission; only if a way to pay for this can be found.” All issues relating to the funding of adult social care will be decided in the next Comprehensive Spending Review, which is due to take place at the end of 2013 or early 2014. However, the Treasury is reluctant to agree to such a reform programme due to the costs involved. This means, in practice, we are no further forward.

Much trailed was the Government’s commitment to introducing a universal system of deferred payments for residential care, meaning no one will be forced to sell their house in their lifetime to pay for care. The Government will work with the care sector to establish how the scheme would work, including when someone will be eligible and what interest or charges would be appropriate, for the scheme to be introduced from April 2015.

Key points:

  • Nothing has changed – there is no new money for the funding of adult social care.

  • All funding decisions are put off until the next Comprehensive Spending Review (date unknown, but not expected until late 2013 or early 2014).

  • The Government has accepted the commission’s proposals in principle and they will form the basis of a new funding model. However, the Government is clear this will only be the case “if a way to pay for this can be found”.

  • There is still a risk that the proposals will be misunderstood, as they were when the Dilnot Report was first published.

Ultimately, the biggest potential failing of the white paper is the risk that individuals might believe the situation on the funding of care is sorted and funding has been found or allocated. This is not the case and therefore the need for financial advice is as important as ever.

Tony Mudd is divisional director, tax and technical support at St James’s Place

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  1. put the threshhold to £50000 to start with at least the poorer of the elderly would not lose nearly everything.but please do it soon before more of the poor elderly lose out.

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