August 2012

Below is an update which includes key actions from the White Paper, additional proposals from the funding report and brief information on the Draft Care and Support Bill including the consultation. Inclusion London will be providing an information paper on the Draft Care and Support Bill in mid to late September.

The White Paper gives an outline of the government’s plans or ‘vision’ for the future of care and support. The Bill is the first draft of the law that will put the ‘vision’ into action. The funding report puts forward suggestions for the funding of the care system in the future. Many of the proposals are repeated in both the White Paper and the funding report.  
The Draft Care and Support Bill (the Bill) is out to consultation - the deadline is 19 October. More information and the full text of the Bill is available at: http://careandsupportbill.dh.gov.uk/home/
The ‘Caring for our future: reforming care and support’, White Paper, (the White Paper) which sets out the government’s ‘vision’ for a reformed care and support system is available at: http://www.dh.gov.uk/health/2012/07/careandsupportwhitepaper/
You can also find out more about the White Paper and the draft Care and Support Bill, on the Caring for our future site.
A Caring for our future progress report on funding reform (the funding report) can be found at: http://www.dh.gov.uk/health/2012/07/scfunding/

Update

The White Paper contains the government’s ‘vision’ of the care and support system for the future, while the Draft Care and Support Bill is the  draft law, which will put the contents of the White paper into action.  The funding report repeats some of the plans put forward in the White paper and also provides proposals for funding social care in the future. This update provides information about the key proposals in both the funding report and the White Paper and also gives brief information on the Draft Care and Support Bill.

Some actions proposed in the white paper and the funding report will be welcomed, while others are disappointing:   A new ‘national minimum eligibility threshold’ highlighted in both the White Paper and the funding report should end the postcode lottery that has developed. However, this will not be implemented till 2015. Another initiative that is delayed till 2015, is Universal Deferred Payments, which will be appreciated by older disabled people moving to a residential/nursing home, so nobody will be forced to sell their home in their (or their spouse’s) lifetime to pay for costs. Legislation giving an entitlement to a personal budget is a positive move, but the portability of care proposal in the White Paper and Draft Bill only allows for existing care packages to continue until a reassessment takes place rather than the transfer of existing or equivalent care packages to the area where a disabled person has moved to, as being proposed by Baroness Campbell’s, Social Care Portability Bill.

However, it is the lack of firm plans for the long term funding of care and support that is the yawning gap in all the proposals, as these decisions have been delayed till the next spending review. This is very disappointing as without a funding strategy the crisis in care will continue. 

Also the progress report on funding indicates that the government is not intending to action all the Dilnot commission’s recommendations on funding, for instance:

• Dilnot suggested that individual contributions towards care should be capped at £25,000-£50,000, suggesting £35,000 as an appropriate figure for a lifetime contribution.  The government has suggested a higher threshold such as at £75,000.
• The Commission proposed a rise in the means-tested threshold, from £22,250 to £100,000. Rather than accepting this, the government mentioned the possibility of ‘a different level’ and suggested a voluntary scheme which people could opt into or out of or private insurance schemes.

The government has said that while they agree with the principles of the Dilnot commission report, they are not going to act on all the recommendations in full, because of the current economic crisis.  Since the publication of the progress report on funding care Dilnot has pointed out that his proposals would only amount to one thousandth of the government’s total public spending. The Guardian newspaper  highlighted the NHS had underspent on its 2011/2012 budget by £1.7billion -  the same figure Andrew Dilnot had proposed could bring about real reform for long-term care in England.

Below are proposals from the White Paper and more details on the funding report. 

Actions in the White Paper include:

• Ensuring that no-one’s care is interrupted if they move.
• Legislating to give people an entitlement to a personal budget.
• Developing, in a small number of areas, the use of direct payments for people who have chosen to live in residential care, to test the costs and benefits.
• Better provision of information on care services. 
• Investing in joint funding between the NHS and social care to support better integrated care and support.
• New capital fund to support the development of specialised housing for disabled and older people, (£200 million over five years).
• Legislation to introduce a clear duty on local authorities to incorporate preventive practice and early intervention into care commissioning and planning;
• Protecting people from abuse and neglect will be put on a statutory footing. 
• Appointment of Chief Social Worker by the end of 2012

Carers/Care workers

• Extending the right to an assessment to more carers, and introducing an entitlement to support to maintain their health and wellbeing.
• Placing dignity and respect at the heart of a new code of conduct and minimum training standards for care workers.
• Training more care workers, also the intention to double the number of care apprenticeships to 100,000 by 2017.

The government is suggesting that private investors fund charities to provide support through ‘Social Impact Bonds’  or other initiatives.  

Progress report on social care funding reform
As an overall principal the report agrees with the Dilnot Commission’s model of ‘financial protection through capped costs and extended means test’. However, as mentioned above, it is not intending to implement the commission’s recommendations for caps and mean testing in full. The government has said that this is due to the current financial constraints.

The government has suggested various ways of paying for care apart from universal systems, these include a voluntary scheme whereby individuals pay contributions and are rewarded by having their care costs capped.  The document also speaks of the so called ‘benefits of insurance’. However, it does say that universal approaches will also be looked at with stakeholders.

As mentioned above the universal deferred payments will be introduced: ‘People that cannot afford reasonable residential care charges without selling their home will have the choice to defer the fees until they are ready to sell.’ The loan will be provided by the local authority and will cover food and accommodation costs as well as care costs.  However, it is not clear what ‘reasonable’ residential care charges are and local authorities will be able to charge sufficient interest to cover their costs. 

Draft Care and Support Bill

Below is brief information about the Draft Care and Support Bill.

The Draft Bill contains 3 Parts plus the ‘Schedules’’

• Part 1 (clauses 1 to 53) covers adult care and support
• Part 2 (clauses 54 to 77) covers health provisions
• Part 3 (clauses 78 to 83)  covers general provisions

There are also 8 Schedules which contain additional details on some of the clauses.

Part 1 on adult care and support covers:

• General responsibilities of local authorities
• Meeting needs for care etc.
• Assessing needs
• Imposing charges and assessing financial resources
• Who can have their needs met?
• What happens after the assessments?
• Who can receive direct payments?
• Establishing where a person lives, etc.
• Safeguarding adults at risk of abuse or neglect
• Transition for children to adult care and support etc.
• Enforcements of debts
• Miscellaneous
• General

More information and the full text of the Bill is available at: http://careandsupportbill.dh.gov.uk/home/
The government is consulting on the Draft Bill.   You can post comment on the government’s webpage or comment by email to: careandsupportbill@dh.gsi.gov.uk
Or by post to:
Draft Care and Support Bill Team
Department of Health
6th Floor
Richmond House
79 Whitehall
London
SW1A 2NS

You can comment on each part of the draft Bill and you can answer questions by topic:

• Comment by clause

You do can comment on as many or as few clauses as you wish. 

• Answer questions by topic

Inclusion London will be producing an Information Paper in mid to late September to support DDPO in their responses. Inclusion London intends to send comments on the majority of clauses in Part 1 Care and Support as well as clauses involving education and training in Part 2 as we think these clauses will hold the greatest interest for disabled people. 

The deadline for the sending in your comments to the government is 19 October.