Paul Burstow MP writes: Social care’s little secret – it’s never been free

None of us know if we will need care in the future, or how much it might cost. But we do know that 1 in 4 of us will face care costs of more than £50,000. What’s more, 1 in 10 will be unlucky enough to face care costs of more than £100,000 in our older age. This is social care’s nasty little secret.

Right now, local councils decide how to spend money on care and support. As a result, there can be big differences between care and support in different areas. Access to support can vary depending on where you live, irrespective of whether or not you have the same care need as someone else. All of this means we have a system that leaves people utterly confused about what help they will receive.

But social care doesn’t just matter because of the costs. It matters because it goes to the very heart of our society where families are the bedrock of care. I don’t believe it’s the business of Government to force people to care for their loved ones. But it is the business of Government to help them if they do so. That’s been our focus in Government over the past twelve months.

First, the Spending Review secured an extra £2bn for social care by 2014. A total of £7.2 billion extra support for social care over the next four years including an unprecedented transfer of funds from the NHS to social care. Through this, Government are finally recognising through funding that health and social care are two sides of the same coin.

The second is being clear as a Government about what social care can achieve. Last November, I set out the Government’s vision for social care which outlined our commitment to provide greater control to individuals and their carers by extending the roll out of personal budgets to give individuals the freedom to decide what their money is spent on. That vision also delivered on our manifesto commitment to provide guaranteed respite care by making over £400million available in additional funding over the next four years to the hundreds of thousands of carers who work over 50 hours a week. And of course there is funding.

Last July we set Andrew Dilnot and his fellow commissioners the challenge of answering the question: ‘how do we strike a fair balance between individual’s responsibility and the State in funding care and support?’ One year later and we are very shortly about to receive his answer. Andrew Dilnot and his fellow commissioners have been blunt that reform comes with a price tag.

There is no magic solution that can shield people from catastrophic costs, instantly reward thrift and make a rotten system fair. This week a survey conducted by the housing and care charity Anchor of 2,000 adults across Britain, found that 44% believed the government “should cover all social care costs for older people”. It’s easy to forget that without personal experience many people won’t know the kind of catastrophic costs that can be racked up through social care. But many people also won’t know that social care isn’t free. Never has been, and never will be. So when you hear all three parties saying that the ship has sailed on a wholly tax funded social care, the truth is that the ship never really even left the dock.

We must therefore make sure that people don’t look at the Dilnot plan through rose tinted glasses by comparing his plans with the fantasy of free care. If funding reform is to be secured during this Parliament it will require give and take. But it will also demand recognition of the times we are in and the fact that the deficit we inherited from Labour casts a long shadow. So although funding reform may be essential; it is not sufficient in itself. The questions that the Government put to Andrew Dilnot are just some of the questions that need an answer. The events at Southern Cross pose questions about the market in care, the abuse scandal at Winterbourne View raises questions about safety, and the Law Commission has posed questions about the social care law.

Don’t expect next week to hear the Government’s final word on social care. The Dilnot report will mark an important milestone on the road to reform, but there are other questions and more milestones to come. There will inevitably be challenges on the way, but I firmly believe that by working together, we can finally begin the process of turning the page on social care reform.

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This entry was posted in Op-eds.


  • formervoter 2nd Jul '11 - 10:16pm

    Aftet your attempt to privatise the NHS – and your listening exercise hasn’t fooled anyone, we know you still intend to privatise it – I don’t believe a word you say. I think you should resign.

    You have revealed yourself to be a shill for corporate profit. You want to organise care for the elderly so that familes can be fleeced of their savings, homes and inheritances. There is nothing here that cannot be done through general taxation, if you weren’t throwing the money away on tax cuts for bankers and foreign wars.


  • “The events at Southern Cross pose questions about the market in care”

    No they don’t they show the present system doesn’t work, the question is what are you going to do about it; the answer I fear is feck all.

  • Barry George 3rd Jul '11 - 1:30am

    Slightly off topic but I would be interested to read Paul’s view on the news that….

    A government department [has] warned that a key Tory policy on welfare reform could result in 20,000 people being made homeless in the UK

    I would be happy to read Pauls justification (as a Liberal Democrat) for supporting a coalition that will knowingly make people in this country homeless ?

    and whether he supports welfare reforms that appear so draconian that….

    A group representing 270 disability charities [are] launching legal action to obtain a judicial review of the government’s plans for welfare changes.

    Charities for goodness sake ! We are hardly talking about Arthur Scargill…

    When stories such as these start to appear on the news I feel sick that the party that I have supported all my adult life could have anything to do with such policies…

    Do we really have to wait until thousands of families are living on the streets before we wake up to this blatent attack on the poor and disabled that is only made possible by Liberal compliance to Tory ideoligy ?

  • Dave Warren 3rd Jul '11 - 10:31am

    The fact is successive government have left the social care system in chaos.

    Thirty years of neglect and mismanagement can’t be put right overnight.

    It easy to sit on the sidelines throwing stones, Ministers like Paul have to
    the difficult job of trying to sort out the mess they have inherited.

  • Ruth Bright 3rd Jul '11 - 11:24am

    Like all our candidates in the 2005 GE I stood on a ticket of “free long-term care”. As Paul rightly points out this was bunkum. There is no reason for Dilnot to set the cap as low as £35,000.

    To give an example. I have relatives who bought a house for just under £3,000 in 1968 it is now worth about £700,000. Alas, they no longer live in that house, but had they done so at the point they needed long-term care why on earth shouldn’t they have had to sell it to pay for their new permanent residence in a residential home?

  • Malcolm Todd 3rd Jul '11 - 11:29am

    That there are serious challenges in funding and organising social care for an ever-aging population cannot be doubted, and I don’t pretend (unlike some people here) that there are easy answers. But please avoid the faux-rigorous, debate-limiting rhetoric of phrases like “the fantasy of free care”. I know that social care has never been free. That doesn’t mean that funding it entirely from general taxation is a “fantasy”, unless you consider every proposal to do something differently from how it was done before as a “fantasy”. (The fantasy of electoral reform, perhaps; the fantasy of state support for part-time students…)

    However social care is funded it will have to be paid for. Doing so from general taxation may well be the best way to do it – like with anything else, we need to engage the public in a debate about priorities. But the idea that it’s impossible because it hasn’t been done before is dishonest and unworthy of a party that likes to present itself as the one most willing to entertain original and unorthodox ideas.

  • Steve Jarvis 4th Jul '11 - 11:44am

    I have never been able to see why people with assets of hundreds of thousands of pounds should have their care funded by those much less wealthy in order that they can give their cash to their (probably also well off) middle aged children when they die. I understand that selling one’s home is probably an unwelcome admission that one’s independent life is over, but those fortunate enough to have the money should pay for their own care. If that prompts people to spend rather than save we will at least get some economic benefits.

  • Matthew Huntbach 4th Jul '11 - 1:31pm

    Ruth Bright

    To give an example. I have relatives who bought a house for just under £3,000 in 1968 it is now worth about £700,000. Alas, they no longer live in that house, but had they done so at the point they needed long-term care why on earth shouldn’t they have had to sell it to pay for their new permanent residence in a residential home?

    I live in a house that was BOUGHT for £3,000 in 1969. It isn’t worth £700,000 now, wouldn’t even sell for anything like that, but it would sell for a lot more, high enough for it not to be affordable were I buying it on a mortgage based on my salary alone.

    My mother-in-law died after being placed in residential care just one week after the charges started coming in, which would mean we would have had to sell the house we instead inherited (you are given a 12 weeks period of grace if mum has to go into care before you have to pay from her estate). There is an interesting spin-of into discussion euthanasia this could lead to, but …

    When I used to argue about housing in the days when I was a Young Lib and my parents were council house tenants, I was told my calls for higher taxation on inheritance, capital gains etc were due to “jealousy” because I did not stand to get any. Now I am told they are “hypocrisy” because I have benefited (at least as long as my wife puts up with me).

    The real point here is that isn’t this a very stupid lottery? If your parents die suddenly, you get the lot. If they die very slowly, you lose it all in care charges. Couldn’t we arrange things better than that?

  • David Evershed 4th Jul '11 - 3:18pm

    It is right that the taxpayer pays for an older person’s health treatment.

    However, why should the taxpayer pay for their day to day living expenses such as accommodation, food, heating, lighting, TV rental and so on.

    There is no reason to have a cap on care.

    After my mother had a stroke, she had to move into a residential home. Whilst there was some state support for the health care the main cost of the home was paid for many years from the proceeds of my mothers home. Why should I expect the state to pay for that so I can receive a bigger inheritance?

  • Matthew Huntbach 5th Jul '11 - 11:29am

    David Evershed

    After my mother had a stroke, she had to move into a residential home. Whilst there was some state support for the health care the main cost of the home was paid for many years from the proceeds of my mothers home. Why should I expect the state to pay for that so I can receive a bigger inheritance?

    Why should you receive a smaller inheritance than someone whose parents died suddenly having never needed residential care? Wouldn’t it be better to have the state pay, but for there to be an inheritance tax to pay for it and even things out?

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