Many more to fund own social care if Conservatives win

By Savi Hensman

May 21, 2017

Many people will lose the right to council help to pay for their social care if the Conservatives win the general election. A bold manifesto pledge would deal a heavy blow to numerous low and middle income families and further undermine social security principles.

While some would be better off, thousands of people receiving care in homes they own, along with their younger relatives, would be badly affected. Social inequality would be likely to increase. At the same time a proposed extra levy on staff from overseas (also in the Conservative manifesto) would almost certainly drive up care costs, while the right to a year’s unpaid leave from work for carers would help only a few.

The worsening crisis in social care has not only caused misery to those not getting desperately-needed help. It has also had intensified the chaos in the NHS by making hospital discharge harder. But according to the Institute for Fiscal Studies, “the Conservative plan makes no attempt to deal with the fundamental challenge of social care funding.” The King’s Fund and Nuffield Trust were also critical.

The National Pensioners Convention was even more blunt. “The Conservative’s manifesto pledge on social care offers the worst of all possible worlds for millions of older people and their families. It’s a Frankenstein’s monster of a plan which bolts lots of bad policies together and still fails to tackle the real unfairness in the care system,” said Jan Shortt, the General Secretary.

“What makes it worse is that to pay for this proposal, around nine million pensioners are going to lose their winter fuel allowance and all pensioners will see the value of their state pension fall once the triple lock is removed.”

Despite widespread criticism, Damian Green, the work and pensions secretary, has told the BBC that the Conservatives will not "look again" at these plans.

Originally, people paid National Insurance and other taxes when able to do so and contributed to society in other ways. They expected that they and their families would, when needed, get healthcare and support with personal care and basic tasks.

This was not only just and humane but also practical, even from the viewpoint of more enlightened sections of the ruling class. Those entering the workforce, or returning after being unemployed or ill, were more likely to be fit and healthy. Employees need not be distracted by worry about frail older or other relatives needing assistance or their own future survival.

However, from the outset, while NHS services were mostly free, social care was part of a separate system, in which local authorities had a key role. Various attempts to integrate these were not very successful. However charges tended to be modest.

Having social care arrangements in place in community settings also made it easier for disabled people to become independent, including not being trapped in institutions. This involved changing outdated practices and often overcoming patronising attitudes. While the notion of 'care in the community' could be misused, the availability of support in or near people’s own homes was valuable. This also meant that, while families and friends might offer extensive support, there was less strain on relationships and greater equality and freedom.

This has gradually been eroded. The number of people needing support grew as life expectancy increased, but local authorities did not have funding to match, especially against a background of tax cuts and loopholes for the rich. It became increasingly socially acceptable to treat social care users seeking council help as a drain on public funds.

Meanwhile, the NHS increasingly refused to meet the support costs resulting from long-term health conditions such as dementia. This applied even to people who at one time might have been in non-acute hospitals. Some still managed to get NHS continuing care, especially if they or their advocates were articulate and knowledgeable. But many did not.

Local authority-subsidised support, most often delivered at home (domiciliary care) or via centres, has been increasingly restricted to those with the highest levels of need and even then is often inadequate. Those with more than £23,250 in assets are expected to fund their own care, though – apart from the third or so in residential care – their property is not taken into account. According to a recent Aviva report, typical savings and investments for UK families are only £3,134, but 64 per cent own their own home.

It was widely felt to be deeply unfair that those unfortunate enough to have to move into a care home should risk losing almost all their savings, with their homes having to be sold after they died, to recover costs. The government pledged to set a cap on how much anyone would pay, after which their care would become free.

The Conservatives have reversed this in their new manifesto. Indeed, those cared for at home too will have their property value taken into account, though the notional amount left will be at least £100,000 when their house or flat is sold after death.

This might seem a generous legacy. But the actual cost of care is often considerably higher than that funded by cash-strapped local authorities, if extra support is bought to make life more tolerable. And householders may need to borrow against property to pay for adaptations, as well as compensating for low pensions.

In addition, housing and education costs have soared while wages have largely stood still or fallen in real terms. So older people are often using equity release to help pay for their children’s housing or grandchildren’s education. Far from having £100,000 to pass on to their heirs, pensioners may be left with hardly anything.

Those worst hit might be carers living with disabled relatives. For instance, a daughter providing about 50 hours’ care a week, on top of 20 hours’ council-funded support, to enable her mother to stay at home, could find herself homeless as well as coping with bereavement.

Another immediate effect might be to reduce local authority influence over home care costs, which might rise steeply. Hospital discharge might become even harder, as patients feared that even modest home care costs could result in their property having to be sold. The longer-term impact, as numerous ordinary families stopped owning property and ended up at landlords’ mercy, would be harder to predict.

In some ways it is admirable that a major party should propose a measure likely to upset their core voter base as well as many to whom they hope to appeal. However the direction in which this seeks to move the UK is worrying.

The further erosion of government commitment to social security principles, including that of National Insurance, is also significant. Low and middle income households would increasingly risk stark financial hardship if a member became ill or disabled. If this proposal goes through, it will cast a dismal light on society’s values.

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© Savitri Hensman is an Ekklesia associate and respected commentator on welfare and other issues. She is author of the book Sexuality, struggle and saintliness: same-sex love and the church (Ekklesia, 2016): http://www.ekklesia.co.uk/node/22613 and has been involved in seeking greater inclusion.

Ekklesia's General Election theme for 2017 is #Vote4CommonGood. This will be explored by writers and researchers from different perspectives and backgrounds, as well as analysis of the different party manifestos in relation to the principles and policies we have advocated for many years.