Social care kicked into touch

What principles muffin?

varian

What principles muffin?

I was thinking of an objective examination of the principles underlying social care, who gets it and who pays for it, and what the fairest solution is. Don’t worry, I was not ascribing any principles to the current policy makers in Number 10…

Exactly muffinthemoo. Nothing is ever about good policy. It's all about manipulating vote shares.

Quite, growstuff. No principles involved.

westendgirl

What happened to the "clear plan "that Johnson had. in 2019 ?
Another of his broken vows ?

covid

greenlady102

westendgirl

What happened to the "clear plan "that Johnson had. in 2019 ?
Another of his broken vows ?

covid

I don't really understand what you mean. Johnson claimed he had a plan in 2019. How has Covid affected that?

growstuff

greenlady102

westendgirl

What happened to the "clear plan "that Johnson had. in 2019 ?
Another of his broken vows ?

covid

I don't really understand what you mean. Johnson claimed he had a plan in 2019. How has Covid affected that?

well the money has had to go elsewhere

I doubt very much whether there was ever any intention to put money into paying for social care. As nobody knows what the promised plans were, it's difficult to know.

The idea would almost certainly have been different from what George Osborne proposed ie raise the cap before people paid for their care. It might have involved some kind of insurance scheme. Who knows?

It really isn't a case of money being used for Covid which could have been used elsewhere. I'm afraid that's all smoke and mirrors.

The issue is - and always has been - whether inheritances should stay intact. Wealthier people with valuable properties will, of course, want their money to go to their children. Others would argue that such a system favours intergenerational wealth and would ask why children should benefit from their parents' wealth and why the state should pay so that children can inherit?

Covid really isn't an excuse. This is about Johnson claiming to have a solution to a problem which is impossible to solve to everybody's satisfaction and people wanting to believe him.

I do wish this problem weren't expressed in a way that brings it all down to inheritance, as though that is all that concerns people. It's not just about that, it comes down to a simple question about why, when two people have both paid tax and NI all their lives, and one has spent and the other has saved, the spender gets free care and the saver does not. It is about fairness.

I fully understand that not everyone is able to save, and would very much like to see a way of changing that. It is, however, a separate issue, I think.

I'm afraid I don't agree with you Doodledog. When all is said and done, that is what it's all about.

Doodledog

I do wish this problem weren't expressed in a way that brings it all down to inheritance, as though that is all that concerns people. It's not just about that, it comes down to a simple question about why, when two people have both paid tax and NI all their lives, and one has spent and the other has saved, the spender gets free care and the saver does not. It is about fairness.

I fully understand that not everyone is able to save, and would very much like to see a way of changing that. It is, however, a separate issue, I think.

The harsh answer is that state pensions and associated care costs are a Ponzi scheme. National Insurance is not and has never been hypothecated to pay future liabilities.

In a Ponzi scheme, some poor rube is always left holding the bag. The actual calculation in altering our current scheme of how to pay for elder care is a calculation of which rube should be holding the bag at the time.

That's as may be, muffinthemoo, but the fact remains that when it comes to paying out, the way things are done now protects the rich, who will always be ok, protects the poor, who will be looked after at least reasonably well, but screws the people in the middle who will end up with nothing after a lifetime of working and prudent living.

growstuff, I know we disagree, but please don't presume that you know my motivation. I feel strongly that this is about fairness - it is certainly a sense of injustice that makes me feel angry about it. Life should not be a lottery beyond what insurance companies would call Acts of God, which can't reasonably be legislated for.

If people are unable to trust that the provision they have made won't be swept away, what incentive is there for them to be 'good citizens'?
A sense of duty? That does not incentivise those who spend (and I'm not saying that they shouldn't - just that there should be a level playing field).
A desire to have control over their future? That would work if such control were fairly allocated. As it is, people are not even able to give away their belongings if they need care - they are allowed a meagre amount of their own money and everything else is taken from them, whilst others get care free.

I honestly can't think of a single way in which this is fair. We all know that life is not fair, but we don't need to legislate to make it less so.

Former Health Secretary Jeremy Hunt pushes government on social care

news.sky.com/story/we-will-deliver-matt-hancock-insists-plan-to-reform-social-care-will-be-set-out-this-year-12338911

I agree with * Doodledog*. It needs to be a fair system. Of course there are those who spend their money and don't think about the future as the government will look after them. It's not fair on those who have worked hard to buy a home and save and would like to leave what they don't use to their children.

No government is ever going to grasp this nettle - it will sting too much.

When I was selling my home to pay for my OH's care, I know that my DDs did not think for one passing moment that this was spending their inheritance - they just wanted their Dad to get the best of care. It simply did not enter into their thoughts.

The truth is that under the present system, those who have money or a house to sell will be able to choose where they are cared for; those who don't, whether because of profligacy with their cash or simple lifelong poverty, will not get that choice. And, believe me, it makes a massive difference: the homes that SSD wanted me to look at for my OH left me weeping in the car park. No way, just no way, was my OH going to go there. Hence the need to sell up.

The system where the NHS has to take responsibility for care is just plain evil - it relies on:
- people simply not knowing that the scheme exists - it is all run on ignorance
- NHS staff not telling them about it and doing the legal assessments
- when the assessments are done, they are done wrong.
- people not having the knowledge to appeal wrong decisions.....or indeed the money - a solicitor will do it for you for £2k - there are specialist ​firms making a mint out of this.

The only way is for a fully state-funded system of quality care funded through a ring-fenced hike in taxation. Is any government going to do this? - No. Does ring-fencing ever work? - No

Why would BJ want to get enmeshed in this?

He never had a plan.

I would just like to say that at the extremely good, dementia only care home, where my mother spent nearly the last 8 years of her life, a good many residents were council-funded. My mother was self funded, and obviously paying more than local authority rates, as AFAIK is invariably the case with care homes that take both.

They all had exactly the same sort of rooms and received the same care.
So it’s not always true that such homes are dreadful.
It was an Abbeyfield, which I dare say may make a difference.

We looked at some more expensive care homes, which usually had more ‘stylish’ decor, but which certainly did not strike us as better, and in some cases rather the reverse.

Social care needs a form of national insurance, to become free at the point of use.

Our social care system is a reflection of our “marketised” society and it is not a good one. When privatisation of the care system started in the 80s when I was working, it promised more choice and better quality. I’m sure we’ve heard that before!

The current private model is very precarious and not sustainable without self finders paying towards those who are not self funded. Large chains are often backed by private equity, and when this fails there are frequently many care homes involved. I don’t not believe it is possible to make a profit out of the elderly without services and care suffering.

If we want decent care for our relatives and care for ourselves as we age we simply have to pay for it. I believe we should re nationalise the care system, paying for it out of tax. We can better regulate LA Care Homes, including adequate training and pay for the staff. I don’t believe it is unaffordable when the government can find money for vanity projects such as a new Royal Yacht. Huge sums are spent by LA towards care at present, despite their budgets being depleted year on year, and keeping people in hospital when they cannot be discharged into the community must also be costing millions. The only thing that was wrong with the LA model of care was lack of funding.

Ring fenced taxation doesn’t unfortunately work. We have this fixation with low tax, but countries with better social services do pay higher rates of tax.

I was a social worker in hospitals when the privatisation of care homes began. The LA homes were well run - proper standards, staff supervision and training - I always used those over the private homes because I felt more secure about them.

And then the standards rapidly dropped - inspecting homes is all very well, but the standards that they regard(ed) as good did not tally with my standards. The inspectorate is hopeless - I could barely believe those homes that were considered good when they were and are far from it.

Private organisations can only run homes at a profit if they charge exorbitant fees or pay their staff peanuts - most do both.

It truly is a broken system - and it is not just about funding; it is about standards of care.

I too think that care should be free at the point of need and we somehow need to work out a way to fund it. I also think that low taxation is not really a good thing when so much in society is lacking. We need to fund care in all forms whether it is doctors and nurses, hospitals, baby clinics etc. The people who run the places need to be adequately paid and not expected to live on a pittance and worry where the next meal for their children is coming from.
I was brought up in a house where my father believed if you earned the money you paid the tax and at that time the tax percentage was higher and if you were buying your house you paid an extra income tax - Schedule A . We are paying a very low tax rate now - I think a rate of 25% is very reasonable - but then I was paying 33% when I first started working in the 1960s.

I do agree that the majority of care homes should be run by local authorities, i.e. not for profit. OTOH I don’t see how the sort of 24/7 care increasing numbers of people are going to need, can possibly be taxpayer funded for everybody - even if provided in not-for-profit care homes.

I know she was highly unusual, but my mother was 89, with already pretty bad dementia, when she finally moved into her care home, because she was no longer safe to be left alone even for half an hour. She went on to 97, in a most pitiful state for her last few years.

She was self funded, but we were lucky, in that at the time, interest rates were considerably higher, so we were able to arrange an annuity to cover the difference between her income and the fees until she died.

Of course she went on a lot longer than most - during her time there I saw many residents arrive, decline, and quietly disappear.

After the provider’s assessment, the annuity cost £125k at the time, but I’m sure it’d be considerably more now, and very likely unaffordable. My sister, who worked it out, said we had ‘won the bet’ so to speak, at around the 4 year mark, but it was always a gamble, and TBH although she came from a large and long-lived family, none of them had made it past 90 so we had never really expected her to live for more than about 3 years.

What would happen now, if her funds had run out, would be that the local authority would have to pick up the tab for her remaining years - hugely expensive.

TBH we always considered it something of a ‘luxury’ to be able to choose the time and place, and not be at the mercy of social services, who (understandably, because of the cost) will often wait until family carers of people who can’t self fund, are on their knees with exhaustion, before considering a care home placement.

I agree that it’s not just about funding, but inadequate funding accompanies poor care. The system is very fragmented at the moment and difficult to regulate. One of the primary costs of care is staff, and if profit is to be made staff is inevitably compromised. Funding to LA was reduced when they began to contract to more private providers and standards started to decline.

GillT57

I think it is important that we don't fall for this engineered North South divide stuff, setting people against each other. There are pluses and minuses to both areas. My house may be worth more on paper than the equivalent in some areas of the North for example, but on the other hand, my adult children are unlikely to be able to afford their own home until we both pop our clogs and leave them a substantial deposit. What a nurse or police officer or teacher for example can afford in areas of the North East is vastly different tp what they can afford in the South East, and as for London, well that is another country.

All of this is true, but it still leaves those in the South with geographical mobility which is not available to people in areas where the sale of a family house would not finance the purchase of a shed in another area.

The reverse is true too, with Londoners inflating the prices of houses when they relocate, and buying up the best houses in areas in exchange for the much more modest ones they have sold for huge sums. Look at the way in which prices in Cornwall and the Cotswolds have risen now that Londoners are moving out to work at home and live somewhere with more space.

The impact goes way beyond 'paper money'. To suggest that a rejig of the social care system should perpetuate this by taking into account the need for some people to be able to leave 'a substantial deposit' behind, when others will lose everything is insensitive, to say the least.

Inheritance is not a driver as far as I am concerned - as I say, to me it is about fairness - but this situation acts as a perfect example of why a fixed cap on the amount people would have to spend on care is unfair in the extreme.

How about a fixed minimum on the amount which could be left in the inheritance "pot", which is what George Osborne proposed?

I think social care needs funding exactly as the NHS “ from cradle to grave”