Paying for Social Care

When you started saying that people should sell their house if they’re not going to live in it, but not if they are young, and not if they have some diseases and not others.

I never said that or anything like it Doodledog, apart from of course the bit about selling your house if you're not going to live in it again. Which seems like common sense to me. I think you have filled in some details that I never said and certainly never intended.

Good to hear your MiL has had such good care * Paddyann*. Shame that it varies so much. As you say it's down to lack of political will.

Alegrias1

^When you started saying that people should sell their house if they’re not going to live in it, but not if they are young, and not if they have some diseases and not others.^

I never said that or anything like it Doodledog, apart from of course the bit about selling your house if you're not going to live in it again. Which seems like common sense to me. I think you have filled in some details that I never said and certainly never intended.

I did ask if you would expect cancer patients to sell their homes if they weren't going to need them, or if you only applied that to old people who no longer needed theirs . I don't think you said no, but can't remember - is that what you would prefer to see or not?

Oh good grief.

Free healthcare in all circumstances. That's it.

There does have to be a line somewhere, or the Health system would be responsible for all the ills of society though. Housing, environment, poverty, etc etc all play a huge role in people’s health, both physical and mental.

I am a true backwoods woman on this. I think if you have a house then you should pay for your care. You do not have to sell, but the Local authority can put a charge on it.

Whys should someone with £million in the bank and a rented home expected to pay for all their care, while someone with nothing in the bank and £1 million house sits smugly knowing that they will eb able to pass on the value of the house to their children.

I expect to pay my way to the end. I would be ashamed to do anything else if I have assets enough to do so.

The state should only step in when people are unable to pay for their care. I also see no cause for raising the savings limit either.

Whys should someone with £million in the bank and a rented home expected to pay for all their care, while someone with nothing in the bank and £1 million house sits smugly knowing that they will eb able to pass on the value of the house to their children.
No reason. I don't think that assets should be split between money in the bank, valuable possessions and houses either. But I do think that there should be a level playing field when it comes to health and care. To reiterate, that does not mean that I believe that there is a level playing field elsewhere in society, not that I would not like to see that reduced.

As it is, if you have savings you have them drastically reduced or confiscated to pay for care, when those who have not saved get it free.

If you are unlucky enough to get cancer, you are looked after (even when it is clear that you have a house you will not be able to live in again), whereas if you get dementia you are charged for your care.

If you live in an area where houses are expensive, you will have a lot left over after a capped charge is applied, but if you live in a cheaper area your savings are wiped out.

All of this is unreasonable, IMO, and to charge only those in work (including the young, those on UC and those on the state pension who can't manage to survive on it) when not charging landlords, those of private means, those who choose not to work and those living on generous pensions makes the unfairness worse.

If M0nica's a backwoodsman, then I'm just a simpleton....

If someone's in hospital, they need intense medical attention. I know that some people get stuck there and have nowhere else to go, but that's not the intention of a hospital.

A care home is somewhere you live. Intentionally. For quite extended periods.

Pay your rent.

I’m trying to get my head round the bureaucracy of a means tested system for accommodation costs for people in hospital. It would be an absolute nightmare. The average length of stay in an acute hospital is 5.9 days.

Agreed. I see no justification at all for charging for any part of a hospital stay.

Charging you for the place you actually live, now. That seems entirely sensible.

growstuff

I agree with you Grany. Labour needs to come up with a realistic alternative - fast. For the first time for months (years), they're ahead in the polls, but that's not because they've done anything great, but because people are fed up with the Conservatives. This should be an own goal for Labour.

I disagree with the quote above. The Labour Party are in opposition at the moment (in case you hadn't noticed). We have no idea what the Tories will have done to the country by the time the Labour Party get into power. That will only happen if the LPs can stop fighting with one another and running down their leadership.

At this point they need to lay out broad brush directions, which is what they have done.

I am not a Labour Party member, nor do I consistently vote for them. However, if the party members don't grow up they will lose again; whoever their leader is and whatever they propose. Strangely the Conservatives don't seem to mind their lot not behaving like grown-ups.

It will have to be done in care homes, though, as the cap only applies to care costs, and not medical or accommodation.

Medical will, presumably be free (or at least already paid out of a lifetime of contributions), and we have no detail about the accommodation, but it will be charged.

The calculations will be complex, I agree.

The devil is in the detail. Well so they say anyway. It will be interesting.

I agree that the nursing/caring boundary needs to be clarified. But if someone has cancer and is being treated in hospital then they have a clear need for nursing and medical care, and has been only too clear to me in the last few years, the moment that need for nonstop nursing ends, out you go and if that means to a care home, you pay for your care.

My experience is that the majority of people in care homes do not need nursing, just care.

I know the big problem is dementia, but even then, most dementia patients seem to need care and supervision and not nursing. However, there are types of dementia and stages of dementia that do require nursing and I think these can and should be defined and nursing care provided at the expense of the NHS.

If hospitals want to pay patients to pay for accommodation and food then they are going to have to up their game considerably. When I said, further up this thread, I think, that if I was asked to pay for my food, I would opt for self-catering, I meant it. Overall individual dishes may taste OK, but overall I was appalled by the limited range of available when DH was in hospital, the way meals had to be ordered 24 hours in advance, the appalling lack of fruit and vegetables and the feeling that generally the food was nutritionally inadequate.

Alegrias1

If M0nica's a backwoodsman, then I'm just a simpleton....

If someone's in hospital, they need intense medical attention. I know that some people get stuck there and have nowhere else to go, but that's not the intention of a hospital.

A care home is somewhere you live. Intentionally. For quite extended periods.

Pay your rent.

That is one way of looking at it or, you could say, that the person in hospital needs care they cannot receive at home and so does the person in a care home. If you think people are any more "intentionally in a care home" than they are in a hospital, you cannot have had much to do with care.

There are people "intentionally" in housing, flats, etc., designed for retirement but that is an altogether different kettle of fish.

It has taken us until now to realise that mental illness is a health issue (unless it is Alzheimer's) but I do wonder when we will realise that many of the chronic conditions are also a "health" issue, whether they come with older age, are there from birth or aquired during our lives.

Doodledog

It will have to be done in care homes, though, as the cap only applies to care costs, and not medical or accommodation.

Medical will, presumably be free (or at least already paid out of a lifetime of contributions), and we have no detail about the accommodation, but it will be charged.

The calculations will be complex, I agree.

We already do the calculations for the LA. They want a breakdown of everything and will try to negotiate a reduction as "She doesn't need xxxx" So they want us to have an apartheid system where some of our residents get something like 1 to 1 time, or a shopping trip and others don't so they can knock £10 off the bill. Thankfully we don't do that, they can have a breakdown of our costs but it isn't a menu.

M0nica

I agree that the nursing/caring boundary needs to be clarified. But if someone has cancer and is being treated in hospital then they have a clear need for nursing and medical care, and has been only too clear to me in the last few years, the moment that need for nonstop nursing ends, out you go and if that means to a care home, you pay for your care.

My experience is that the majority of people in care homes do not need nursing, just care.

I know the big problem is dementia, but even then, most dementia patients seem to need care and supervision and not nursing. However, there are types of dementia and stages of dementia that do require nursing and I think these can and should be defined and nursing care provided at the expense of the NHS.

If hospitals want to pay patients to pay for accommodation and food then they are going to have to up their game considerably. When I said, further up this thread, I think, that if I was asked to pay for my food, I would opt for self-catering, I meant it. Overall individual dishes may taste OK, but overall I was appalled by the limited range of available when DH was in hospital, the way meals had to be ordered 24 hours in advance, the appalling lack of fruit and vegetables and the feeling that generally the food was nutritionally inadequate.

It's pretty obvious that people in care homes don't need nursing care, if they did they'd be in a nursing home.

When it comes to care OUTside hospital the distinction between health care needs and social care needs must go for the purpose of funding. Needs are needs and must be funded under whatever system is chosen, but from the "patient's" point of view the nature of those needs is irrelevant - they have needs - end of. There is a whole market out there of legal firms making shed loads of money helping people to argue the case between these two things, because the one is means-tested and the other is not. There is also a drain on NHS resources in people employed to decide which is which and hear appeals.

This piece of nonsense needs to go.

Isn’t every ailment there is potentially defined as a ‘health issue’ though PippaZ? I just can’t see how there could be a system with no definitions which encompassed all the potential health issues and the payment for them.
There is some logic to social needs being managed through local authorities as they are now, which is that social needs cover so much more than care needs in a health sense. The risk is that the NHS becomes the catch-all but won’t deliver - and I honestly don’t think it can, it’s just too big an ask for one organisation to deliver everything, and the NHS is the public whipping boy already - the Tories would use that as the reason for privatising.

It really needs someone with a 'ready to go' social care plan, doesn't it?

Oh.

you cannot have had much to do with care.

Yes, you're correct. Fair enough. I'll stop having an opinion then. ?

People in care are not patients. Patients in this context are people in hospital or nursing homes who need nursing and medical care.

Several members of my family have been in care homes and appropriately placed there because they needed care and supervision for a variety of reasons. When, as happened in a couple of cases, they later developed illnesses that meant they needed nursing care, they were moved into nursing homes.

I find it very strange that it is some of the most vocal left wingers who think all care needs should be met by the state regardless of the income or assets of those needing care. Too many seems to be defending the right of those with assets to cling onto them and hand them on to their children, even though that can only be done at the expense of the poorer people in Society and I find that quite shocking when it comes from those who say they want to close the enormous economic gulf in society.

I believe in a fair system of taxation that takes payment up-front, provides a 'cradle to grave' package of health, education and care for all (I would include social housing in this package) and then leaves people to make choices about how they spend the money they earn.

I despise means-testing, as it removes choice from people, and works against those who are neither rich enough to buy themselves out of the systems that support the majority, nor poor enough to get help from the state. It results in a race to the bottom, in which a 'there are people worse off than you' mentality drags everyone down to the level of the poorest, rather than allowing people to work towards bettering their standard of living and that of their children.

If we had a fair tax system, it would not be at the expense of the poor, as higher earners, and those with income streams from other sources than work would be taxed at a higher rate, and the gap between the disposable incomes of rich and poor would shrink, and things would be fairer at the start. I find that entirely compatible with a broadly left-wing view.

In any case, I think that 'you have left-wing (or right-wing) views so you must think X' are baseless. Political affiliation is not signing up to a series of rules or agreeing to a set of thought processes.

I "despise" the idea that it's acceptable to hold on to a million pound house so that you can pass it on to your kids, and have other people pay for you to live in a nice care home. As somebody said above, I'd be ashamed of myself.

Yes, I know you do.

I've yet to be convinced by anything you've said though. I will never be persuaded that means testing does anything other than keep the aspirational poor 'in their place'.

Don't run away with the idea that I have a million pound house, or vast amounts in the bank either, for what that's worth. I am absolutely not speaking from a position of 'I'm alright Jack'.

I don't think I have any need to feel ashamed, thanks.