The Dilnot Commission on Funding of Care and Support has called for a radical reform of the present system, which sees thousands sell their home to meet open-ended bills. It proposes a rise in the means-tested threshold, from £22,250 to £100,000, and a £35,000 lifetime cap on adult social care costs.
Radical changes in social care funding
Describing the current system for funding adult social care in England as ‘not fit for purpose’, and in need of ‘urgent and lasting reform’, the Dilnot commission proposes widespread changes that will bring clarity and consistency, while ensuring that all income groups are better off than they are at the moment. The most striking measure is a lifetime cap on social care, so that nobody is expected to pay more than £35,000 for their social care, regardless of their assets or income. The level at which state help stops is currently £23,250. Dilnot proposes increasing this threshold to £100,000, so that many more people receive support. Those with assets above the threshold will continue to be self-funding, but their expenditure will stop once they reach the £35,000 ceiling.
Care costs and living costs treated separately
The proposed cap on care expenditure does not apply to living costs. As in Scotland, where care is currently free, living costs will be treated separately. Here too, Dilnot envisages a limit, of between £7,000 to £10,000 annually. The commission sees these as being paid for out of pension income.
Post code care assessment lottery to end
A failing of the current system which Dilnot addresses is the ‘post code lottery’ for home care, whereby those in need of domiciliary care only receive council support if their needs are sufficiently acute. The Commission recommends that ‘substantial’ needs are adopted as a national minimum. It also calls for portability of assessments, so that those in receipt of care packages can move without fear of losing their entitlement.
Care cost insurance encouraged
Although Dilnot calls for care costs to be capped, the commission recognises that paying out £35,000 will still cause difficulties. It envisages a new range of insurance products, which people can use to lessen the impact of care costs and a form of pension access, whereby annuity income could be used to pay for care. Equity release is also discussed as a funding solution, particularly for those in need of domiciliary care who wish to remain in their home. Local authority deferral of fees is also encouraged by Dilnot, taking the pressure off hard-pressed families at a time of great stress.
Changes welcomed by Which?
Calling for the government to act on the Dilnot Commission’s recommendations, Which? executive director Richard Lloyd, said: ‘Consumers tell us that long-term care is their top health care priority so we welcome these recommendations and urge the Government to pursue them as a matter of urgency.
‘If private insurance is to play a part in funding long-term care, then we need to learn lessons from the past, where products have either failed to meet people’s needs or have been mis-sold. This will be a new market with a clean slate so it’s important that strong consumer protection is in place from the start.’
- For more details on the current system, read the Which? guide to long term care.
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