Who’s solving the social care crisis?

Annette Jack

The Conservative Party’s pledges on social care made the headlines yesterday, but have they gone far enough to address what is becoming widely accepted as a crisis in social care?

Sir Andrew Dilnot, former government advisor, and author of the Dilnot Review, doesn’t think so.  He argues that, whilst the key pledges of introducing a ‘social capital floor’ of £100,000 and extending the freedom to ‘defer payments for residential care’ are a move in the right direction, one key recommendation from his review has been ignored.

That recommendation suggested “an individual’s lifetime contribution towards their social care costs, which are currently potentially unlimited – should be capped.  After the cap is reached, individuals would be eligible for full state support.”  Dilnot argues that without this, the Government has failed to address the real crux of the issue in social care.

The issue is this – at present no-one is certain how much they will end up paying for care.  You could never need social care in your lifetime, or you could go into a home at 65 and stay there until you’re 95, costing hundreds of thousands of pounds.

This high level of risk means that insurers are unwilling to enter this market, and people cannot act as effective consumers of social care.  As Dilnot says “it is a bit like saying to somebody you can’t insure your house against burning down, if it does burn down then you’re completely on your own, you have to pay for all of it until you’re down to the last £100,000 of all your assets and income.”

He argues that the Government is the only body in a position to take on this level of risk within the social care market.  If they do not provide social insurance to remove this level of uncertainty the market will not receive the investment it needs from insurers and consumers, and it will remain stagnant, unable to meet rising demand.

It is not clear why the Conservatives chose not to include this recommendation.  Perhaps a threshold for the many was more widely appealing than insurance that would only impact a few?  Either way, the crux of the issue remains.  As Chris Ham of the King’s Fund said “Instead of fundamental reform, these proposals involve tinkering with a broken system and do not provide the sustainable solution that is desperately needed.”