Review by Helen Barratt
Speciality registrar in public health
The Archbishop of York, Dr John Sentamu, has called on the Prime Minister to address the current 'crisis' in the elderly care system. The Archbishop said it is 'widely acknowledged' that the existing funding arrangements are 'unfit for purpose' as pressure grows on the government to reform the social care system. (1)
Social care includes the support services that help frail and disabled people remain independent, active and safe. Such services are funded in a separate and more localised way than the NHS. Whilst the NHS was established as a centrally directed service, largely free at the point of use, personal social services remain the responsibility of local councils and subject to means-testing. (2)
Despite an ageing population, there has been little increase in gross spending on social care for older people in recent years. Consequently, councils are having to restrict help to smaller numbers of older people with the most intensive needs. Individuals with assets totalling more than £23,250 are liable for their full care costs: a quarter of those aged 65 today can expect to spend over £50,000 on care in their lifetime. (3)
Following the General Election in May 2010, the coalition government acknowledged the urgency of reforming the social care system to ease the cost burden many individuals face. (4)
A commission, chaired by the economist Andrew Dilnot, reported in July 2011. In his report to the government, Dilnot recommended that individuals should not have to pay more than the first £35,000 of their care costs. Additionally, individuals with assets, including their homes, totalling less than £100,000 should not have to pay for care. (5) The cost of the Dilnot proposals is estimated to be around £1.7 billion.
The Commons' Health Select Committee has recently called for the government to implement the findings of the Dilnot Commission, noting that older people are being let down by a social care system in which they are 'passed like a parcel' between services. The government has however yet to accept the recommendations, and Health Secretary, Andrew Lansley has referred to them as merely 'a basis for engagement.' (6)
However, in his open letter to the Prime Minister, Dr Sentamu described the Dilnot report as 'a call to action which our country cannot, must not ignore'. Quoting Proverbs, the Archbishop called for a new social covenant that 'assures the weak and vulnerable of proper protection,' stressing the valuable contribution that older people make to a society which increasingly considers them 'an irrelevant burden'. (1) The government has pledged to set out its approach to reform in a White Paper to be published 'in spring 2012'. (7)
