Paying for Social Care

Alegrias1

I don't think you should have to sell your house if you need medical treatment.

I think you should sell your house if you're never going to live in it again. And use the proceeds to pay your way.

Seems the government paying to house you becomes acceptable when you're old, but not before. If you were young you'd be a feckless scrounger.

It isn't just about being old though is it. When dementia sufferers are unable to walk, to get themselves to a bathroom to wash or go to the toilet, are unable to feed themselves much less do the shopping and cook a meal don't they deserve to be cared for much like someone who has another condition that happens to be deemed suitable for funding?

For some the progression is fast, for others there are years of misery. My relative was unable to live alone over 4 years ago, but the progression has been relatively slow and they were considered end of life 2 years ago and yet the suffering goes on. The home is wonderful, her care is 2nd to none, the cost is high but it is her money, I still cannot understand why she isn't entitled to care, she has a terrible disease but it isn't the "right" type of disease.

When she fell and needed a hip replacement they couldn't get her out of the hospital fast enough, it was OK, she was in a home she didn't need a hospital bed or even physio or follow up. So even when she had a condition that would normally get someone a hospital bed and follow up she wasn't able to get the same level of treatment.

She worked for 45 years, paid her NI and tax, was never a cost to the state, had no children, lived a quiet life with her husband but in her hour of need she isn't eligible for anything, well she gets attendance allowance so she gets under £90 a week which goes towards the £1,300 a week her care actually costs.

Shockingly to me anyway, when she went into the home part of her fee is for the home to pay for a private GP as they couldn't get a GP for all the residents on the NHS. Not fair to the local budget as so many people with high needs in the home. Strange isn't it, a National service but some of the most vulnerable people can't get NHS GPs because they are so vulnerable they have to live in care. I'm not sure if this is still the case, I know there were moves to end this.

Do you think someone with terminal cancer should sell their home to pay for their treatment? They won't live in it again, they won't need it again.

Aveline

You've said this before MaizieD and I wasn't convinced then. I just remember the ghastly runaway inflation that renders currency virtually worthless. I've seen it in Italy, Post war Germany and Zimbabwe. Theory is one thing, practice is another.

What aren't you convinced by, Aveline?

You do realise, don't you, that UK governments since the 2008 global financial crisis have created some £400+ billion? Pure money creation, not 'borrowed' from anywhere, nothing to pay back. That all the money for the pandemic relief was 'created', not borrowed. (Though Johnson has used much of it the way that corrupt leaders do; making sure that it goes into the pockets of his friends and donors). It is a fact that this is what governments like ours, with a sovereign currency are able to do, and have done.

Circumstances in all the countries you cited were completely different from those which apply to the UK. Have you, in the light of all the £billions the UK govt has created over the past 15 years, noticed any runaway inflation resulting from it?

That's what Roosevelt did in the US in the 1930s with his 'new deal', created dollars and used them to get people working. It got them out of depression fast.

The reality is that our government can,(and has) create money. It can do it by buying back bonds, though that just puts money into the hands of the already wealthy who use it to make money for themselves, or by spending it directly into the 'real', day to day economy where it can pay people's wages and support private enterprise. While ever there are resources available inflation won't happen. It is scarcity of resources that creates inflation.

Given that reality, the concept that taxation funds spending cannot be true.

Do you think someone with terminal cancer should sell their home to pay for their treatment? They won't live in it again, they won't need it again.

You might want to read the first line of my 17:31 post again theworriedwell.

Alegrias1

^Do you think someone with terminal cancer should sell their home to pay for their treatment? They won't live in it again, they won't need it again.^

You might want to read the first line of my 17:31 post again theworriedwell.

You might want to read the 2nd line. "I think you should sell your house if you're never going to live in it again. And use the proceeds to pay your way.*

So I ask again do you think someone should sell their home to pay for their treatment as they won't live in it again, they won't need it again.

Your first and 2nd sentences contradicted themselves so I am asking you to clarify, the options being.

1. Terminally ill Cancer patients shouldn't have to sell their homes and pay for treatment.
2. Terminally ill cancer patients should sell their homes and pay their way as they aren't going to live in them again.

Germanshepherdsmum

*Growstuff*, kindly explain how, whilst working full time, claiming no benefits other than child allowance and spending on nothing other than keeping a roof over our heads, putting food on the table, clothing my child, paying usual household bills and paying off the debts my ex left me with, for a good many years, I could be considered feckless by any stretch of the imagination, unless by that you mean begging an abusive man to return so that I didn’t have single parent status? To suggest that I might fit the feckless criteria, whatever they might be, is insulting. I have no idea of your circumstances so can’t comment on whether anyone would make a similar comment about you. These insults do nothing to further the debate, they merely detract from it.

Don't ask me! Try asking the people who would have called you "feckless", if you had had some kind of accident at a time which meant you couldn't work again and needed help at a time when you had no assets and/or a low income.

PS. And try reading properly rather than being so aggressive!

PPS. Thank you for answering my question. You obviously wouldn't have liked being called "feckless" by people who know noting about your circumstances. I don't think many people would.

So I ask again do you think someone should sell their home to pay for their treatment as they won't live in it again, they won't need it again.

For the third time...

Nobody should have to sell their home to pay for medical treatment.

If you are going to spend the rest of your life in a care home, and you are the only person who lives in your house, and you think as a general principle people should take responsibility for their own living costs, sell your home and live off the proceeds, like any normal human being. Or don't sell your home, but use whatever resources are at your disposal to pay for your food, clothes, cleaning bills, whatever. Like a normal human being.

But as theworriedwell says, unfortunately many people die in hospital, and some of those have a terminal diagnosis when they get there. By your logic, they should also be asked to 'sell their homes and live off the proceeds', as they won't be living in them again.

Dementia is an illness, the same as the ones that kill people in other ways, so why should there be a difference in the way people with that particular illness are treated?

And what's with the 'normal human being' stuff? In both cases (people with Dementia and people with other terminal illnesses) we are talking about people at the end of their lives, who will be frightened and possibly in pain. We can at least be compassionate when talking about them.

This argument about who's 'deserving' of free support and care (and who's not) - is fascinating, alarming - and horrifying.

The elderly frail are targeted - but not adults with disabilities - I wonder why?

Those needing care, it seems to me, are in the same helpless, vulnerable position as babies and small children. Do we deny them help and support? Of course not.

Why the desire (in some) to limit help to those who've been lucky enough to lead a full, productive, independent life? Why the need to ration support? What exactly is the mindset of those who think that way?

1 I agree with Alegrias that nobody should have to pay for medical care.

2 If somebody needs social care (whether 24/7 or for a shorter time), that should be covered by some form of Attendance Allowance. Residential care is the cheapest form of care, so if AA doesn't cover it, maybe AA needs to be increased. (Incidentally, I think people should receive care in other circumstances too eg when they leave hospital, but that's another thread).

3 People should pay out of their own pockets for the accommodation and food etc components because they would be paying for them anyway. For some, that might need to come from pensions and others from other benefits. If people want better food or nicer surroundings, they'll have to pay for them. If the benefits and pension aren't enough, maybe (as with Attendance Allowance) the amount of pensions and benefits needs to be increased.

4 Nobody in a vulnerable situation should be contributing to the profits of a private provider, which means that residential homes should be run by councils or another state provider.

5 I don't have all the relevant figures, so haven't done the maths. I suspect the total cost would be more than is currently being spent. If so, the bill should be paid by the state. As Maizie has written so many times, this does not necessarily mean tax increases, but if taxes were to be increased, they should be paid for by those with the broadest shoulders - not, as is about to happen, by one specific sector of society (the ones with the least) just so another specific sector doesn't lose so much in inheritances. This latest scheme is a direct transfer of assets from the least wealthy to the most wealthy and does nothing to solve the underlying problems.

My grandma went into a care honest the age of about 86. She didn't have a house that she owned, she had a council house. We knew she wouldn't go back into her little house again, so did she, so she gave it back to the council after 30 years of having lived there.

Now, if it had been her own house, we would have sold it. And she would have had a nice little lump sum. So by what possible metric is it acceptable for an 86 year old to have large sums of money in the bank and expect the state to pay her living expenses?

Not her medication, not her treatment, her living expenses.

You can twist it all you like to suggest I'm demanding money from the old and the sick, but I just find it immoral that anybody would expect to live in a care home and get the state to pay for their living expenses just so their children can inherit.

Hetty58

This argument about who's 'deserving' of free support and care (and who's not) - is fascinating, alarming - and horrifying.

The elderly frail are targeted - but not adults with disabilities - I wonder why?

Those needing care, it seems to me, are in the same helpless, vulnerable position as babies and small children. Do we deny them help and support? Of course not.

Why the desire (in some) to limit help to those who've been lucky enough to lead a full, productive, independent life? Why the need to ration support? What exactly is the mindset of those who think that way?

Hetty I think you'll find that adults with disabilities often don't get the help they need either.

I agree with you Alegrias. I think there should be differentiation between medical, care and living expenses.

growstuff, true - but I said that, in their case, there's not this huge argument about who deserves help - and who (somehow) doesn't. It's an ageist thing, entirely targeted at the elderly - yet here are elderly folk doing it!

Would you charge living expenses to people in hospital for other illnesses?

I know that in my local hospital it costs £10 for 24 hours of TV, and that 24 hours is from when the money is paid, so patients could be in clinics or asleep for a lot of the time - the watching time doesn't accrue. When people have nothing else to do, TV can be a lifeline. Obviously, over a week that adds up to £70, and add in unconscionable parking costs (or bus fares) for visits, and a couple on a low income are going to be shelling out a lot already before you start charging for food and laundry or whatever counts as 'living expenses'.

If you would discriminate between illnesses and only charge living expenses to those in care homes, on what grounds would you do so, as Dementia is an illness? My stepfather had Lewey Body, and died in a nursing home. He needed 24 hour medical care, in the same way that someone suffering from other illnesses, but he had to pay for his care when people with cancer, or any of the other things that see people off did not.

I know I keep saying it, but nobody should have to pay for care if we sort out the tax system. That way, the low paid won't pay as much, and higher earners will contribute more, which is fair.

And Alegrias, if that comment about 'twisting' was aimed at me, it is unfair. I am using your own words, and asking the same question that was asked by theworriedwell - if people with one terminal illness should have to sell their home and live off the proceeds 'like a normal human being', why should that not apply to someone with a different terminal illness?

I was not twisting anything - I called out your unpleasant turn of phrase.

Is it not possible to discuss this without aggression and snide comments?

Hetty, you may well be right to say that it's an ageist thing.

Hetty58

growstuff, true - but I said that, in their case, there's not this huge argument about who deserves help - and who (somehow) doesn't. It's an ageist thing, entirely targeted at the elderly - yet here are elderly folk doing it!

It's the oldest trick in the book to get people squabbling amongst themselves. It takes their minds off the bigger picture.

BTW I'm not sure it is an ageist thing. I know a very wealthy family with a very disabled child (now young adult). They have fought to get the child as much support as possible. They lived in the same small village as I did and I heard much tittle-tattling and bitching about how the family could have afforded the support without getting state aid, even though they paid for a number of carers themselves.

Alegrias, in principle, of course, your argument makes sense. Then, it's lost in translation somewhere and fails in practice.

'Not her medication, not her treatment, her living expenses' normal living costs, yes - but we don't live in hotels costing thousands a week, do we?

I think you'd be very surprised at how medication and treatment costs are defined - and accounted for. Basically, only things a doctor or nurse is legally needed for, so almost nothing. (I remember the panic when some idiot 'carer' put Mum's ear drops in her eyes).

Everything else, not 'medical' is 'social care' (mobility, washing/dressing, toileting, feeding etc.)

If you are disabled and wheelchair-bound by a stroke - your treatment, expenses, life, accommodation - everything, in fact - depends entirely upon your age.

If you're young, it's a medical matter, past retirement - it's suddenly 'social care', it's an elderly thing, normal and expected. Just one day older or younger can change things!

Doodledog How long do people in cancer spend in hospital? I don't know the answer, but I bet it's not that long. My Mum had terminal cancer, but was sent home until a couple of days before her death. It cost my sisters and me quite a lot of money with travel expenses, taking time off work and buying her special food and anything else we could think of to distract her. We didn't get any of that back.

Maybe there is a case for charging people in hospital for food (which has been discussed before on GN) but it would probably cost more to administer than the food itself because most people stay in hospital for a relatively short time.

No, I don't think people should spend years or months in a care home without contributing to their keep. They are effectively saving the money they would spend on themselves.

Hetty I think you've made some very good points. Maybe there needs to be a thorough audit of how money received by care homes is spent and accounted for. The current changes don't do any of that.

Hetty58

growstuff, true - but I said that, in their case, there's not this huge argument about who deserves help - and who (somehow) doesn't. It's an ageist thing, entirely targeted at the elderly - yet here are elderly folk doing it!

This is why we need to recognise the truth about how national finances work and start thinking differently about how we, as citizens, want our public money to be spent.

Instead there is squabbling over who deserves, or doesn't deserve a share of a 'pot' that is deliberately, though mendaciously, presented to us as being finite.

I guess that the length of time people spend in hospital varies - I suspect it’s unusual, but didn’t someone on this thread mention a relative being in for two years?

Why does it matter? Are you saying that people should start to pay for non-medical things after being ill for a length of time, rather than having their diagnosis determine whether or not they are charged?

And would charging for accommodation only apply to single people with the ‘wrong’ illnesses after a certain length of time? Paying rent and bills for a partner and any children to live at home as well as ‘hotel costs’ in hospital for the patient would be ruinous to most families (or would the changes only apply after a certain age?)

You can’t seriously want a system under which everyone gets medical care free, but only if their illness is not on a list of particular long- term ones, and only if they are not over a certain age and are widowed, divorced or single, with £X in the bank, in which case a complicated formula will apply to charge them for services that are deemed ‘social’ rather than medical?

It does seem as though it’s a particular (and very specific) demographic being singled out for charges, doesn’t it?

Why not just make if free for everyone at point of need, and charge everyone in advance via tax?

My final word on the subject.

When you go into hospital, it's because you are ill and they will try to make you better. It might not be possible to make you better, you might never leave that hospital. I expect society to pay for whatever you need while you are there.

If you go into a care home to spend your final months/years there, it's because you live there. It's your home now. If you have another home somewhere else standing empty, I don't expect society to pay for you to live in a communal setting so that your other home can stand empty or be passed on to your descendants when you're gone.

It’s a shame that is your final word, as we cross-posted and it doesn’t address any of the anomalies I mentioned.

It seems to me vindictive to single out one very specific set of people for charges, whilst simultaneously arguing for a free healthcare system for all.

Well I'm still here. I'll have a look.

Nope, no anomalies.

Hospital care should be free, including food, tv, parking, whatever. Irrespective of what is wrong with you.

If you are well enough to leave hospital and live in a non-medical setting, you can't expect anyone to support you in having two homes, no matter how old you are.

It's pretty clear to me.