The government’s much-vaunted plan for health and social care reform announced this week raises as many questions as it provides answers. As is so often the case the devil lies in the detail.
The proposals put forward in the plan may prove to be inadequate and could be misleading in terms of whatever comfort they bring to people concerned about the costs of funding their later life care.
Two numbers worthy of particular scrutiny are the total to be invested in adult social care and the lifetime cap on the care fees individuals will be expected to pay.
The plan includes a commitment to invest £5.4 billion into adult social care over the next three years. It sounds like a big number but there are currently 490,326 people living in care homes in the UK (Source: https://www.carehome.co.uk/advice/care-home-stats-number-of-settings-population-workforce), and in 2019-20 there were 838,525 adults receiving some form of long-term social care (Source: https://digital.nhs.uk/data-and-information/publications/statistical/adult-social-care-statistics-in-england-an-overview/2020).
That figure therefore works out at £71 per care home resident per week, compared to an average weekly cost of care of between £681 (residential care) and £979 (nursing care); and £41 per adult per week receiving long-term care.
It’s worth noting too that the £5.4 billion sits inside the total £12 billion per year announced for health and social care. As the Institute for Fiscal Studies points out, since 1983-84 average real terms growth in health spending has been 1.4% higher each year than planned growth. (Source: https://ifs.org.uk/publications/15599).
As the article’s title puts it, “an ever-growing NHS budget could swallow up all of this week’s tax rise”.
Then there’s the £86,000 cap “on the amount anyone in England will need to spend on their personal care…” Once that threshold is breached people “will only have to contribute towards daily living costs”. My understanding from speaking to the owner of one chain of care homes is that these living costs could be as much as half the total fees.
So even after someone has reached the £86,000 cap, if they are paying average care home fees of £681 per week, they could still face an annual bill of £17,700. For nursing home residents it could be as much as £24,454 based on the average cost. In many areas it could be substantially more.
There is also the question of what happens to the £86,000 cap in the future. In 2020 care home fees rose by 3.2%, while nursing home fees increased by 4.7% (Source: https://www.which.co.uk/news/2021/03/care-home-prices-continue-to-rise/).
If the £86,000 threshold is discounted each year by 4% to account for care home fee inflation, it’s ‘worth’ £70,000 in real terms after just five years, and yet there is no mention of the cap being increased in the future.
Fixing social care is unarguably of huge importance, and the willingness of this government to grasp the nettle is to be applauded. But this week’s proposals may have done more to highlight the scale of the problem than they do to provide a solution to it.