Social care - who should pay?

That's not nice, Monica. Perhaps we should ask residents to wear a badge to show whether they are self-funding or poor.

There's not a single council care home in County Durham. They are all run by private companies.

If we are going to pay for the NHS and continuing care, both should be brought back under council or government control.

It's not just a matter of care being paid for. If there are a million people on zero hours contracts, they cannot be expected to contribute to care.
Another thing I have never understood is why people have a cap on the amount of NI they pay. NI should be paid on all pay, not just up to a certain limit.
Not many people think of NI in the same terms as general tax, but that's what it is.
We could have NI being paid all our lives and hypothecated to care and health.

If you are self-financing and do not want to subsidise those relying on state finance there is a simple solution. Check whether the care home you are going into accepts residents from social services. If it does look elsewhere.

Quite a number of homes do not accept Social Service residents because they do not consider that they can deliver acceptable care for the pittance social services will pay.

cari that is why I think some form of care insurance is necessary as for all sorts of reasons individuals may not be able to have sufficient funds for their social care. In fact I would argue that the majority won't.

In the past people did not live as long and therefore far fewer people had dementia. When families looked after older people it was often in circumstances we would consider quite unacceptable today. Granmother' sharing bedrooms with younger children or sleeping in the living room, being left alone for hours, or theoretically looking after or being looked after by very young children. Thank God all that is in the past.

The other thing we need to do is keep a sense of proportion, not every older person ends up in a care home. DH and I both have a parent who were one of eleven children. On DH's side only one of them or their spouses has ended up in care. In my family it is 2. Yet both of us come from long-lived families, All but 2 of my father's siblings lived into their late 80s or early 90s. One, in her 90s, still lives independently, looks after her house and garden and drives locally.

Why is it that those who pay for their own care have to subsidise those whose care is payed for out of taxes. That is a double whammy.

You shouldn't have to. If all care medical, mental or social, was paid for out of taxes it would be like schools and the current NHS service. We would all be fighting for it to be the best it could be and we would all expect to receive a decent service. Above and beyond that there will always be some (currently roughly 10% in each case for schools and health) who want to top that up but it would be a choice.

The issue is much more with the fact that no past government has faced up to the problem even though it was apparent there would be one.

I certainly agree with Nonnie's comment that Whatever the answer the government should look at the long term implications, not just the next election.

This may be of interest Cari

I don't think it is just because we are alive but also that we are alive with complex issues. My paternal grandmother also had complex issues but these could not be treated as they are now so did not cost the then taxpayer and, I don't doubt, contributed to her death in her 60s. My mother, on the other hand, born in 1920 has had (as well as other interventions) two hip replacements and a knee replacement which, had they been around at the time of my grandmother would have been appropriate for her needs and would have kept her mobile for much longer and she would, therefore, have probably lived longer.

However, the Cinderella of treatment is for Dementia and other mental health issues. The needs for mental health are sidelined into 'social' care although that is only true is you do not equate mental health problems with medical ones. This is why I say we need a combined service.

Cari, I am puzzled at the claims that 'we did not plan for it'
What does that mean ? We do as people have done in the past, saved money and have a house, more than this, you cannot plan for.If people rent property and have no savings, they will be cared for in Council care homes etc.
What has changed , well, nothing that I can see.

I think living longer plays a part but also both partners working so there is no-one to take responsibility for aged parents. Also, possibly, many more separated or single people battling on on their own.

I think that family used to care for older family members more in the past.
I have no problem in thinking that some of childrens inheritance should go on caring for ourselves when needed.
A part of the money for the house, when sold should go on care.I needs to be decided what is a fair amount, at the moment it is almost all.
Social care divides from medical care at the point when we can no longer do everyday things and care for ourselves.

Whatever the answer the government should look at the long term implications, not just the next election.

I have a relation who has cashed in her pension and spent it in her 50s because she didn't see why she should pay for care in her old age. I doubt she is alone. What incentive is there for people to save for their old age if they know that whatever their assets are they may be taken to pay for their care?

We live in a society far different from the one I grew up in. We never expected anyone else to fund our lives, we always saved so we had an emergency fund and led a lifestyle which enabled us to do so. We saved so we have sufficient in our retirement to keep ourselves but today's young people live in a society where everything is instant and they don't have to wait for things they want. They expect a comfortable lifestyle without scrimping and saving to buy a house. They leave university with a huge debt which encourages them to think it is OK to owe large sums of money.

Why is it that those who pay for their own care have to subsidise those whose care is payed for out of taxes. That is a double whammy.

Surely if we all paid NI on our pensions that would make a huge contribution towards these costs. It seems unfair that the state pays for your care if you are dying of cancer but not if you have dementia. Why are certain illnesses paid for and others not? Why can't it be based upon the person's ability to do things for themselves rather than the cause of their inability to cope alone?

The state has never saved the money we pay in PAYE/NI etc, it has always been the working generation who has paid for the old and needy.

I think first there needs to be a clear published definition about what is social care and what is medical care. There seems to be no clear definition.

This includes a clear definition, with examples of what level of medical need will qualify for NHS continuing care and what will not. Currently the NHS and Social Services keep tossing this from one to another like a hot potato to the utter confusion of family members trying to sort everything out.

Once that is sorted I think everyone should pay for their own care to the extent of their assets, including their house. I have no truck with the arguments about inheritance, Of course, like most people, I would like to leave an inheritance to my children, but if my care needs make that impossible then too bad.

The reason I think this is because of who would be otherwise paying for our care. Even when we bought houses, there were many people who could not afford to do so. By definition if you bought a house you were already working your way up the income scale. On the whole, children from owner occupied families, lived in better areas, went to better schools, got a better education, better jobs and had a good start in life compared with their non-house-owning compatriots. Now when their parents die they hope to inherit a large sum of money.

It is sheer selfishness to demand that all those less fortunate than themselves should pay, through their taxation, for the care of all those better off older people so that, on the whole, their better off children can add to their advantages by inheriting a large lump sum.

pat6633, your argument is very shallow. Home owning is a very pleasant way of life with freedom to do what you like within your home and the opportunity to move house as and when you want to. What is more, through schemes like equity release, the capital you have built up can be released to help fund a comfortable retirement. Paying for your own care means that you can exercise choice about the quality and location of any care home you go into. If you depend on Social Services, and many people have to, you have little or no control over which home you are placed in or the quality of the care

kittylester I absolutely agree that one's family should not be expected to contribute to their parents care, beyond the loss of an inheritance

I think a Commission should be set up to look at the whole issue - both NHS and Social Care - take it away from politicians. Andy Burnham's suggestion was dubbed "death tax" and Teresa May's was dubbed "dementia tax" - it's a political hot potato.
Once a Commission has decided what is needed then the issue of how it's funded can be addressed - over-60s to pay NIC, higher income tax, estate duty, patient fees - these are just some possibilities.

Why do people expect to leave (or to get) an inheritance? Except for the rich this expectation is surely something relatively new? My inheritance from my grandparents (all 4 of them) was a small amount of money (enough to buy a twin tub and an easy chair, which latter I still have and use daily) and a few pieces of old furniture (table, wooden chairs, sideboard). I was glad to get these but had never expected anything.

There is no way that I would want my family paying for my care and it is totally wrong in principle that they should be even asked to contribute. It is bad enough that my savings and other assets should be used to pay for care and my family get no inheritance.

What is wrong with a form of dedicated social care national insurance?

Similar to the NHS insurance.

So free at the point of need?

Definitely not the family. Things are hard enough for them as it is.

They have taken away any incentive to work hard and buy your own home. If it's all going to go on care what is the point? May as well spend everything you have while you can enjoy it

I agree with you MiniMouse. I actually had to look up what is included when we talk about 'social care'. It's easy to make assumptions and jump to conclusions.

Which report is coming out this week Cari? We can make sure we're all talking about the same thing then

You're right - it is a difficult subject. I think part of the problem is that it's fallen upon many of us too late to be able to plan for it as we might have done. For us it's always been about working for your pension and then pension will see you through retirement. This didn't even enter the equation and so suddenly the whole outlook has changed. We have scrimped and saved all our working lives to buy and keep up our (modest) home and liked the thought that this is the legacy we would leave children and grandchildren. The likelihood is now that this will not be the case. Clearly the money has to come from somewhere (where are the magic money trees when you need them?) but without clear information far in advance how were we supposed to plan for our futures? We worry about it a lot

The first thing, in my opinion, would be to make sure, right now, that no other generation is in this position again and make the National Health Service the National Health & Care Service.

Personally I think the small amount of the NHS that is paid for from our NI should be taken out of there and the rest that comes from general taxes taken out of there and one tax NHCSI be paid from the start of work until we die.

I know governments do not like hypothecated taxes like this because the cannot play around with them but it would be more obvious what percentage of GDP is being used (I understand ours is lower than most rich nations) and we would be aware of the ceiling amount that the NHCS would get. All this obviously depends on Health and Care being merged but there are, from what I read, large savings to be made by doing this.

To underline what I am saying: NI would then be for working age and end of work (pension) benefits and NHCS would be for health and care.

There is, of course, the deficit from the fact that our generation in particular has not paid this during their lives but are now needing the care. This will probably have to be some sort of capital tax so some sort of estate tax seems unavoidable. What I, personally, would not want to see is only those who get, for instance, dementia, being taxed in order to pay for the care they need. If we spread the load it is less for everyone.