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Social Care Reform and help got the elderly

(137 Posts)
Whitewavemark2 Fri 03-Jan-25 06:46:51

“Ministers are to launch a historic independent commission to reform adult social care, as they warn older people could be left without vital help unless a national consensus is reached on fixing a “failing” system.
The taskforce, to be led by the crossbench peer Louise Casey, will be charged with developing plans for a new national care service, a Labour manifesto pledge, in the biggest shake-up to social care in England in decades. Millions of pounds in funding to improve and adapt homes for older and disabled people and help them stay out of hospital are also being announced today, as part of a wider package of support.

Writing in the Guardian, Wes Streeting said: “It will take time, but Casey’s work will finally grasp this nettle and set our country on the path to building a national care service that meets the urgent need of our generation, guarantees quality care to all who need it, and lasts long into the future, no matter which government is in power.”

Guardian

ronib Sat 04-Jan-25 09:28:45

M0nica I was very heartened to hear that an Anglican church near Shrewsbury gave a full Christmas meal, a present and entertainment to a group of people on Christmas Day. My own church is engaging more in bringing the community together too. It can be done and is a worthwhile mission too. Don’t be so dismissive. I much prefer the church to be involved than this excuse for a government.
Making your own plan is essential seems to me. Best done in advance.

Notagranyet24 Sat 04-Jan-25 09:41:49

Grantanow

Of course social care is going to cost money raised from taxes and the main argument will be about the cut off point for those able to contribute but I am disappointed that Labour, having had 14 years to plan, can only kick the can down the road. Streeting was an effective Opposition MP but is clearly a lightweight when pressing for funds from the Treasury for social care.

And the Tory plans for when they get back into power are??????

PoliticsNerd Sat 04-Jan-25 09:44:00

RosiesMaw2. An increase in Employers' National Insurance (NI) contributions does raise concerns about rising labour costs and potential negative impacts on employment.

However, there can also be positive changes in the jobs market due to this shift. Looking at both sides will give a clear view rather than the panic the right-wing media tries (and, it seems succeeds) to create.

mae13 Sat 04-Jan-25 09:45:40

Lathyrus3

I’d welcome some kind of insurance scheme. Even now, on my pension, I’d prefer to pay a monthly amount knowing that quality care would be there if I needed it.

At the moment I’m afraid to spend money in case I need it in the future and find myself doing calculations about how many weeks I could afford before the savings and the house sale ran out.

Not a fan of insurance - it's a dirty word in my book. At the first whiff of any kind of mandatory health insurance scheme the vultures will descend in droves.

PoliticsNerd Sat 04-Jan-25 09:55:46

I think your politics still override the need to plan winterwhite, e.g., Getting the British public to accept that the hallmark of a civilised society is how it treats its old and its sick and thus support the cost.

Politics don't make things happen, they just set the framework for making the plans. That has been done. It's now time to review and implement the plans.

I do agreed the squabbling over political minutiae will continue but we don't have to involve ourselves in it - or we may. It is a choice.

Doodledog Sat 04-Jan-25 10:11:02

Every time the government tries to improve things the moaners come out in force. It must be hard work being so relentlessly negative.

Yes, care will cost money, but it already does! It doesn’t do so fairly though, so some have to spend all their money and sell their houses to subsidise those without the means to pay.

Many people of all political stripes disagree with that- it is a major fear for older people - and if a way can be found to charge everyone a little bit along the way so nobody has to be pauperised if the lottery if life means they need social care in old age, then I’m keen for that to happen. I’d like to see geographical unfairness ruled out, too. As it stands, notional ‘caps’ on spending have all been finite, so someone whose house has a postcode premium would still have lots left over after paying up to the cap, but someone who has worked just as hard in another area loses everything. Maybe charging a maximum of X% of an estate would be more equitable?

As it stands, the system allows some to go through life with a free ride, and others are forced to pick up the tab - that has to stop somehow, or it will be too expensive for the ever-shrinking number of ‘economically active’ to cover. Obviously there are those who can’t pay for various reasons, but I’m sure the investigators will have thought of that and be looking at ways to mitigate it.

Paying NI after pension age is a good idea, but again, I’d rather see the burden be spread, so those who work don’t have to fork out for those who don’t, as usual. Also, not all people of pension age are able to work - the differential levels of heath and abilities in older people is the starting point for all of this, and can’t be ignored. Plus, we should all be able to put our feet up for a few years after decades of working. Or maybe we can’t (collectively) afford that? Again, that’s why we need a thorough investigation.

A big problem will be what to do with people like most of us here - those in older age who might have existing conditions but not enough money to plug the gap between insurance and PAYG. I wouldn’t get insurance as things stand, but I am far from unusual in that, so again, I expect the commission to look for ways around it. I guess it will mean one of two basic models - the new system (whatever it turns out to be) is for people under a certain age, so there is time to get funding in place before it starts, or it starts off being inclusive but needs a huge boost of public money. If it’s the latter, which I hope for, for obvious reasons, young people will need to be convinced that they should shoulder that burden, which after so much propaganda about generational inequality could be difficult to pull off. Who would want to pay a lot of extra tax to fund someone who begrudges them a takeaway coffee or ‘the latest phone’? grin.

I am pleased that this is cross-party. I think that is the only way to prevent social care from becoming a political football, with huge amounts of money being spent on initiatives that an incoming government scraps. I think that will be difficult to achieve, however, as we know that Reform doesn’t believe in publicly-funded healthcare, never mind social care, and how that can be factored into a compassionate system is beyond me. But that’s why a commission is needed, rather than a rush to implement an ‘oven ready deal’ that has no substance or credibility.

Anyway, I am pleased with this news. I have no problem with paying in to get out, but recognise that for people of my age (65) it is probably too late to pay my share on an insurance basis, so hope that younger people can be persuaded to do it instead.

Granny23 Sat 04-Jan-25 10:12:06

No mention so far on this thread of the Free Social Care which is provided by the Scottish Government - see -
www.gov.scot/policies/social-care/national-care-service/
I am not saying that the system is perfect but given the pressure on the Scottish Government's budget, it IS is up and running and giving support to the elderly and disabled and their families.

Doodledog Sat 04-Jan-25 10:15:35

My Scottish friend would disagree there. She says that whilst care is free it is all but impossible to get. Maybe that is area-dependent, but it is her experience - she has an elderly and infirm mother.

GrannyGravy13 Sat 04-Jan-25 11:15:32

PoliticsNerd

*RosiesMaw2*. An increase in Employers' National Insurance (NI) contributions does raise concerns about rising labour costs and potential negative impacts on employment.

However, there can also be positive changes in the jobs market due to this shift. Looking at both sides will give a clear view rather than the panic the right-wing media tries (and, it seems succeeds) to create.

What positive changes in the jobs market do you envisage the new NI rates and lowering of eligibility starting point will bring when implemented this April?

Grantanow Sat 04-Jan-25 13:06:15

I doubt the Tories would do any better Notagranyet24, now or later. The Buffoon Johnson claimed to have fixed social care! I think social care is too hot to handle for any Party and it's very unlikely it would be free for all at the point of delivery.

Notagranyet24 Sat 04-Jan-25 13:35:54

Granny23

No mention so far on this thread of the Free Social Care which is provided by the Scottish Government - see -
www.gov.scot/policies/social-care/national-care-service/
I am not saying that the system is perfect but given the pressure on the Scottish Government's budget, it IS is up and running and giving support to the elderly and disabled and their families.

Nothing is free except the air we breathe, there's always a cost even if it's hidden. The question is who has collected the money and how is it distributed and who decides what's fair.
Thanks doodledog completely agree.

M0nica Sat 04-Jan-25 16:45:41

No one has yet mentioned buying limited life annuities when you go into care. These used to exist, but I haven't seen them advertised recently

With a limited life annuity, when someone went into care you would buy an annuity with a lump sum which was guaranteed to cover your care costs until you died. The cost was based on your expected life-length, medical conditions, family history, expected rise in care costs etc. Havin bought the annuity that was the care costs fixed and dealt with.

If you died much earlier than expected you lost out, your actual care fees amounted to less than you had payed in, but if you live for a long time, you would be, as they say, quids in.

Twenty years ago these schemes were quite popular.

growstuff Sat 04-Jan-25 16:59:45

I haven't read this thread in detail, but I don't think anybody has mentioned staffing. There are issues which need to be addressed, which will have implications for training, pay and (very important in the current climate) immigration.

There are also questions about the current models of providing social care, such as whether care in the community is working.

Balancing all the issues and needs isn't something which can be delivered overnight.

growstuff Sat 04-Jan-25 17:02:50

GrannyGravy13

PoliticsNerd

RosiesMaw2. An increase in Employers' National Insurance (NI) contributions does raise concerns about rising labour costs and potential negative impacts on employment.

However, there can also be positive changes in the jobs market due to this shift. Looking at both sides will give a clear view rather than the panic the right-wing media tries (and, it seems succeeds) to create.

What positive changes in the jobs market do you envisage the new NI rates and lowering of eligibility starting point will bring when implemented this April?

Lowering of the eligibility starting point will mean that more low-paid workers will build up years to be eligible for state pension.

If (and it's a big 'if') the extra money is ring-fenced for social care, it could mean that more money is available.

FriedGreenTomatoes2 Sat 04-Jan-25 17:07:50

Many people of all political stripes disagree with that- it is a major fear for older people - and if a way can be found to charge everyone a little bit along the way so nobody has to be pauperised if the lottery if life means they need social care in old age, then I’m keen for that to happen. I’d like to see geographical unfairness ruled out, too. As it stands, notional ‘caps’ on spending have all been finite, so someone whose house has a postcode premium would still have lots left over after paying up to the cap, but someone who has worked just as hard in another area loses everything. Maybe charging a maximum of X% of an estate would be more equitable?

A great comment Doodledog. 👏

David49 Sat 04-Jan-25 17:15:28

M0nica

No one has yet mentioned buying limited life annuities when you go into care. These used to exist, but I haven't seen them advertised recently

With a limited life annuity, when someone went into care you would buy an annuity with a lump sum which was guaranteed to cover your care costs until you died. The cost was based on your expected life-length, medical conditions, family history, expected rise in care costs etc. Havin bought the annuity that was the care costs fixed and dealt with.

If you died much earlier than expected you lost out, your actual care fees amounted to less than you had payed in, but if you live for a long time, you would be, as they say, quids in.

Twenty years ago these schemes were quite popular.

Some companies do offer a lifetime care annuity, you pay a lump sum and the pay you a fixed annuity per month for life. They offer a range of options to suit individuals and the more you pay the more you get per month.

They do not commit to paying all you care needs for life

David49 Sat 04-Jan-25 17:21:17

FriedGreenTomatoes2

^Many people of all political stripes disagree with that- it is a major fear for older people - and if a way can be found to charge everyone a little bit along the way so nobody has to be pauperised if the lottery if life means they need social care in old age, then I’m keen for that to happen. I’d like to see geographical unfairness ruled out, too. As it stands, notional ‘caps’ on spending have all been finite, so someone whose house has a postcode premium would still have lots left over after paying up to the cap, but someone who has worked just as hard in another area loses everything. Maybe charging a maximum of X% of an estate would be more equitable?^

A great comment Doodledog. 👏

That’s fine, but care fees are a lot higher in the South of England than the North, even more close to London

Casdon Sat 04-Jan-25 17:41:04

As are salaries David49.

Doodledog Sat 04-Jan-25 17:44:15

I'm not sure of your point there, David.

If someone has a house worth £500k and the cap on care is £100k, obviously they are left with £400k, regardless of the costs of that care. Someone with an equivalent house in a different area that is worth £100k has nothing. The costs of the care don't come into it, but one person has money left to bequeath, or to spend on making life more comfortable, and the other doesn't.

A lot of the differential in prices comes down to chance, or maybe that in some areas wages are just higher. Either way, it strikes me as unfair that people doing the same job and living in equivalent houses should be treated differently just because of the area they live in. That is systemic discrimination, and a percentage charge (as opposed to a fixed one) would help to even that out.

David49 Sat 04-Jan-25 18:08:22

Doodledog

I'm not sure of your point there, David.

If someone has a house worth £500k and the cap on care is £100k, obviously they are left with £400k, regardless of the costs of that care. Someone with an equivalent house in a different area that is worth £100k has nothing. The costs of the care don't come into it, but one person has money left to bequeath, or to spend on making life more comfortable, and the other doesn't.

A lot of the differential in prices comes down to chance, or maybe that in some areas wages are just higher. Either way, it strikes me as unfair that people doing the same job and living in equivalent houses should be treated differently just because of the area they live in. That is systemic discrimination, and a percentage charge (as opposed to a fixed one) would help to even that out.

“If your house price disparity is so extreme then that is true.

Here in the Midlands £400k buys a nice 4 bed detached”
Up in the frozen north £100k buys a crummy 1 bed flat.

Granniesunite Sat 04-Jan-25 18:09:29

Doodledog

My Scottish friend would disagree there. She says that whilst care is free it is all but impossible to get. Maybe that is area-dependent, but it is her experience - she has an elderly and infirm mother.

I’ve had this conversation before on this forum..

I live in the central belt and I get help for my husband who has alzhimers through Self Directed Support .. it’s invaluable and I know from my carers group that it’s helping lots of people in my area.

My husband would be in a home a long time ago if I didn’t have this support . He’s is also entitled to free personal care from our local authority but I dont use that as I’m very grateful for the help I have and his support team take care of his personal needs.

I have support workers coming in daily…..four hours a day five days a week…. to help me keep him at home.

They shower him shave him give him his meal and medication if required keep him company for that time.

In so very grateful. It gives me a break and time to be me.

You do need a diagnosis of various illness to be eligible for Self Directed Support but I would urge your friend to contact her mothers social worker and ask for this help.

PoliticsNerd Sat 04-Jan-25 18:58:09

GrannyGravy13 in answer to your question.

Rising costs will/may encourage employers:
1. to increase productivity and efficiency because it encourages automation.
2. to focus on hiring more skilled employees who can add greater value to the organisation, leading to a rise in higher-quality jobs.
3. to invest more in developing their workforce to make them more productive.
4. to enhance their staff's skill sets, leading to overall industry improvement and better job stability.
5. to provide enhanced employment packages in order to attract and retain talent, some businesses may respond by offering improved benefits, such as additional training, enhanced health benefits, or flexible working arrangements, which can improve employee satisfaction and retention.
6. to support growth in sectors that support efficiency, such as HR outsourcing, payroll services, and consulting firms that help businesses adapt to changing employment law.
7. to inspire entrepreneurship and innovation, leading to startups focused on providing solutions to help businesses manage their workforce effectively.
8. enhance job security by favouring retaining existing workers over hiring new ones, leading to greater job security for current employees as businesses stabilise their employment strategies.

Not all these changes will necessarily happen and I will have missed some. However, it does show that an instant, gut reaction may only give half the story and is often only about today, not the reality of the future.

RosiesMaw2 Sat 04-Jan-25 19:05:31

However, there can also be positive changes in the jobs market due to this shift
The business community both here in the UK and abroad don’t seem to be seeing these positive changes either hmm.

PoliticsNerd Sat 04-Jan-25 19:26:23

Really RosiesMaw2?

The increase in Employers' National Insurance won't take effect until next April. I expect that both British and foreign businesses operating in the UK are starting to consider how they'll adapt to this change, as implementing those adjustments will take time.

Short-term thinking can often lead to poor decision-making and a lack of logical clarity. Sadly there are some who seem as wedded to it as a small child at Christmas.

Doodledog Sat 04-Jan-25 19:48:00

If your house price disparity is so extreme then that is true.

Here in the Midlands £400k buys a nice 4 bed detached”
Up in the frozen north £100k buys a crummy 1 bed flat.

Really? I’ve never been in the market for either, but I’ll take your word for it, although it doesn’t matter to my point what the figures are or to which areas they apply - the fact remains that a flat fee would be unfair. There will be cheaper and expensive areas even within the same towns, but there are clear discrepancies between more general areas. Saying that a family in one area has to spend every penny to get care and a similar family in another just needs to spend 10% (or whatever) just perpetuates geographical inequality.

There is no ‘cap’ anyway, although it is often discussed as though introducing one would be fair. I am just suggesting that a commission might want to consider that it would not be anything of the kind, and instead introduce a percentage fee, if a fee remains necessary.