A Better Insurance Market Would Help Meet Rising Costs of Adult Social Care

A group of more than 60 government advisors, charity directors and independent experts have signed a letter to yesterday’ Daily Telegraph demanding radical reform to care and home help services. They urged the government to build a cross party consensus and to seize the opportunity presented by the forthcoming social care white paper to deliver a care system fit for the future.

There’s no doubt that the funding of adult social care is one of the most pressing political issues of our time. Life expectancy in the developed world rises by about two years every decade (equivalent to your death receding by about five hours every day). As we live longer, more and more of us will spend longer periods of our old age needing significant amounts of care. Last summer, the Dilnot commission found that people were frightened of this prospect because they did not know what costs they would face.

Press coverage of this issue and today’s letter to the Telegraph tends naturally enough to focus on the national picture and on the costs of care as a proportion of national spend, but in reality this issue is most pressing for local government for whom adult social care is their biggest area of expenditure by far: about £14bn a year.

Councils directly fund about 59% of those in care but they also end up funding about 25% of those who initially fund their own care once they deplete their resources and fall back on the state.Independent Ageing, a recent report by the LGiU found that councils were largely unaware of this ‘hidden’ cost estimated by insurers Partnership to be up to a billion pounds a year nationally.

Dilnot argued that no one should pay more than £35,000 for care bills during their lifetime. The government should implement this suggestion. This will not avoid people having to apply substantial ‘hotel costs’, but introducing a cap will allow an insurance market to expand to fund care home places, pooling the risk among a wider group and reducing the numbers forced to sell their homes.

A better market for insurance to meet care costs is exactly what LGiU argued for in Independent Ageing but this relies on people receiving advice from appropriately qualified independent advisors. Local authorities would be helping their citizens and their own financial interests if they connected people with such advice: but at present only 3% of them do so.

It remains to be seen how the government responds to Dilnot and whether the forthcoming white paper constitutes the “urgent, fundamental and lasting reform” the authors of today’s letter call for.

Irrespective of the national response, however, there are already simple, low cost steps that can be taken at a local level to ensure that people get advice on how to manage their finances and reduce the chances of them falling back on state funded care. That’s a financial issue of course, but it’s also, most crucially, a way of giving people self-determination and dignity in the old age that’s an increasingly common destiny for us all.

Went to the launch this morning by John Denham of the government's 'Strengthening Local Democracy' consultation.  These are my first thoughts on hearing him and skimming the document. The starting point of this consultation is the right one: the recognition that councillors and councils should lead communities, and shape all the local public services, because they have a “unique democratic mandate”. The consultation is a very practical one. Gone is the airy language of ‘empowerment’. Instead John Denham identifies priority areas where he sees scope to increase the role and powers of councils. John Denham clearly recognises that local action will have the greatest impact to tackle climate change. We are pleased to see that he wants to build on the LGiUs carbon trading project which is highlighted in the consultation. Only councils have the understanding of local patterns of carbon emissions as they relate to economic and social progress. The proposals reflect the ideas we have shared in recent weeks with the government, and the work we are continuing with the launch of our Carbon Trading Public Sector programme. Proposals to enhance local democracy in health services are good to see. For too long this massive part of the public sector has been run from Whitehall. The LGiU will respond calling for local primary care trusts to be run by local councillors, who should make up a majority of the membership of the Trust Boards. This simple step will put people who have a mandate into a position where they can exert much more influence in health, and connect health to other key local services, particularly social care. Proposals to extend powers, and the resources, for councils to scrutinise a much wider range of local services, including utilities, will only be worthwhile if they have real teeth. Finally, it is good to see that the government is taking up our proposals to put local government’s role and powers in relation to central government on a statutory footing, including the LGiU’s suggestion for a joint parliamentary committee. The problem with this consultation is that John Denham is approaching localism from the beginning at the end of the government’s term. I asked the Secretary of State today how any of these proposals will see the light of day in the short time before the next election. John Denham’s response is that we, the supporters of stronger local democracy, have to help him persuade his colleagues across government that there is an urgent need and a real demand to localise now. We will be taking up this invitation to redouble our work to take our message to all parts of Whitehall. In the meantime I will be urging John Denham not to wait until the consultation ends ‘in the Winter’ to get on with implementing those ideas that don’t require legislation and where a consensus exists already between local and central government.