Should Gransnet weigh in on care costs?

I notice that the Tories are now wanting to increase the inheritance tax limit to £1million.
Danny Alexander now thinks that once again the Tories are looking at the wrong people, but he will not say if the Libdems will block it. Sitting on the fence will not save his seat. He's asking disaffected Tories to vote for him. I wonder how many of his constituents have property worth over £1million?

This question is on BBC1 at the moment.

Thanks for the link eloethan, interesting to see how other countries approach this.
I think that system of co-payments, with people paying towards the cost of their social/residential care, with perhaps varying contributions according to assets and income, would be fairer than the all or nothing system that seems to apply in England at present.

The whole system of care for the elderly, the costs involved and how the money paid is spent needs to be looked at in detail.

Many homes are wonderful places, a home from home and place of security and safety for people unable to care for themselves or be cared for in their own homes.

However, some are inadequate, poorly run and run on a shoestring despite the cost of living in them being high.
Whilst the residents suffer inadequate care and nutrition, the multi-millionare owners of some of these homes are living the life of Riley.

I agree, jane. My mother in law was self-funding until they realised she could not look after herself at all. She falls over if she stands up, and has dementia now. At least the last time I visited her I did not get called by anybody else's name, just introduced as her cousin.
I think the rules need to be really sorted out if co-payments come in.
Thinking about when my husband was on the LCP, one week we were told he need not worry, it would all be paid by the NHS; the next week we had to fill in a form about what he could and could not do to find out if the NHS would pay or whether he would have to; the third week he stopped eating and drinking and died. That really should not happen.
In Denmark they complain about paying high taxes, but get better benefits on retirement.

jen co-payments have always been a political no-no in the NHS - the thinking seems to have been that it is unfair for better-off people to be able to 'buy' a better level of service or a better drug, or a better new hip, than others can afford.

Perhaps it's time to turn around the way we think of co-payments - perhaps if they were viewed as a contribution to the State system, rather than an individual making a purchase, the idea would be more acceptable.

You ladies write so well! Yes, I think Gransnet should be involved in this issue.
My view is the same as FlicketyB's.
Other points - what do people think about the morality of an elderly person signing over their house to their children (before they go into care)?
And looking at it from the other side, why have fees got to be so high? My Mum paid £250 pw about £13,000 pa when she was in a home, until she died in 2002.

Tricia that is what I mean about the whole system needing to be looked at.

How much of the (eg) £1, 000 per week goes on the elderly person's care and keep, running costs etc, and how much ends up as profit?

Re my post of yesterday (Saturday 11 April 13.57.54)

I was basing it on personal experience of people I knew whose attitude had been to live for the present and not worry about the future. Unlike others I knew who had led frugal lives, denied themselves what they considered to be luxuries (a washing machine!! a decent TV etc)

Flicketyb I was not implying that all those without money had spent it. I didn't think I would need to differentiate between those who never had it in the first place! I was simply making the point that the system is unfair. I obviously didn't word it very well.

The health/social care issue surely also needs to be addressed - don't they merge into one at some stage?

It's a total minefield, so many variations on care and costs.
I shall be forever greatful to Age Concern who suggested the Trust Fund which I mentioned earlier. It meant that my auntie could stay where she was happy, even if I had issues over the years with slipping standards.
She died three years ago not owing anyone a penny, we were able to administer her will so that her great nephews and nieces benefited which was her wish. We could have done no more.

I wouldn't like to have to sort it all out fairly. I can't even begin to imagine where the starting point should be.

My understanding is, and I may be wrong, that signing over a house just before an elderly person goes into care can be challenged as a deliberate depreciation of assets, or something to that effect.

I don't know if it is still the case, but in order for property and assets not to be used to finance care costs or to attract inheritance tax, I believe they needed to have been placed in trust several years before care is actually needed. Wealthier people are usually aware that there are devices that allow the avoidance of inheritance tax and care costs and engage one of the many legal firms that specialise in this sort of work to make the necessary arrangements. I know someone who did this - at that time, there had to be a gap of seven years before the property and assets were disregarded.

Most elderly residential care now is run for profit - and as big a profit as possible. That means hiking up fees and cutting costs. That can result in inadequate staffing levels and poorly paid, under trained and demoralised staff. When I taught literacy to adult learners, one of my students worked in a care home for the elderly and was dismayed at the sort of cost-cutting that went on, which she felt threatened safe standards of hygiene. When she tried to challenge what was happening, the company made life very difficult for her and she eventually left.

Health and social care are ‘social goods’ because when you need either of these services, if you are in serious need, you will be unable to work, to earn money to pay for your needs to be met. You cannot afford to insure against everything and our NHS gives us a universal insurance.

Maintaining citizens in good health benefits the whole community both in terms of a healthy workforce boosts economic production and provides fit soldiers to fight. In 1899 up to 40% of recruits in Britain were unfit for military service! This was a wake up call to government that took them 50 years to rectify.

One person's health may affect another’s for example smallpox, HIV/Aids etc.. That is why we have vaccinations etc. and talk about maintaining herd immunity.

In the UK we decided that everyone should have access to health and this came in 1948. There are now fewer deaths per 10,000 in child birth, breast cancer, etc.

I believe it is easier to standardise health care to meet each need than social care. NICE do their best.

So why then is social care not free?

If you are disabled from an early age it will be. However if you were fortunate to be fit enough to work you are expected if you earned over a certain amount to save and pay your way. There were tax allowances on your pension contributions. Since the 1st of April this year the government have capped your care payments to £72,000 (see LucyGransnet)

I do appreciate that some gransnetters will feel that when a person needs residential care that should be free like the NHS

However the reality is that the cost benefit analysis of health care for all scores better than social care for all. Health for all gives us a thriving workforce but care for all just removes productive people (i.e. making things rather than offering services) from the workforce to become carers. Staying independent and not needing care is cost effective for the country so that is the way things go.

Have not got more time to think about this for longer.

I take your point Emily but find it hard to accept that the motivation of founders of the NHS was simply to provide the country with a healthy workforce.
Surely they were thinking in terms of ending or limiting individuals' suffering too.
In those days they could not foresee the enormous changes in medicine which have prolonged life, but at enormous financial cost. Equally they could not foresee the increased life expectancy that we now have, but which comes for many people with years of debilitating chronic illness which costs the stars both in terms of medication and support.

I think the intention and ethos of the NHS was to ease people's suffering and the distinction between health and social care is an artificial one.
If you look at eloethans link you will see that the among the countries studied, England stands out as making this distinction when other countries do not.
Initially it was hoped the NHS would be free at the point of delivery - it was soon discovered that this was unaffordable and charges for NHS dentistry were introduced within 2 years.
Eye care and prescriptions are not free either - we accept this, so I really think that the idea of co-payments at least for social care should be re-examined.

sorry, costs the state.

Notice that DC when arguing for an increase in the level that inheritance tax hits, said that it is right and proper that people who have worked hard all their lives and struggled to buy a house should be able to leave it to their children. I hope he uses the same argument when considering the cost of care and the way that the state will leave a person penny -less if it deems it necessary.

Obviously not, whitewave. It's only those who have a £1 million pound house who should be able to leave it to their children, not those like my mother in law who has one worth £150,000 who has to sell it to pay for her costs.
Although the government has topped care costs at £72,000 it does not include board and lodging in that £72,000. You still have to pay for what they call housekeeping on top of that.
That's why it needs sorting properly.

Eleothan - I think the time the house is made over to family still needs to be well before admission to a care home. In our case when the time came we had to make Mum's bank statements available to the Social Services, so they could see what was coming in and going out. Don't know if they would have access to documents about transfer of house ownership.

They can get that information from the Land Registry online, Tricia. So can anyone.

It used to be 7 years before, TriciaF. Not sure if it still is now. But there are other rules about if you hand it over, you have to pay rent, etc., so it's not simple.

It obviously makes sense to have a healthy population that can contribute to the society in which they live, but to see that as the only reason for taking care of people is, I think, quite chilling.

This is why gransnet should take up the issue of care, let alone care costs.

www.independent.co.uk/life-style/health-and-families/health-news/a-million-elderly-people-lack-basic-social-care-as-unprecedented-funding-cuts-leave-struggling-nhs-to-pick-up-the-pieces-10170302.html?fb_action_ids=10152756560617401&fb_action_t

www.independent.co.uk/news/uk/home-news/the-5bn-care-home-crisis-that-is-seeing-record-numbers-of-providers-close-their-doors-8591849.html

Relevant to many of the Gransnetters so yes.

Yes I think that Gransnet could put forward good representative views. We have a brilliant NHS but cradle to grave care should be just that. We all spread the cost of medical care between us as a nation and a couple of pence on income tax could cover care costs also. All it takes is political will, I believe that the country would back such a plan. We want good quality care to the end of our lives and I believe that people would be willing to pay for it.

Hate to say it but it won't make a blind bit of difference because there isn't any money to fund care for us oldies so we will have to do it iurselves if we can. Kate Barker did a review of housing supply which didn't do any good.