Care sector in fear of u-turn on long-term care funding

Recent weeks have seen an escalation of political uncertainty over long-term care funding, after the Coalition’s commitment to the financing of a solution was brought into doubt by none other than the former Care Services Minister Paul Burstow.

The catalyst for intense media debate can be traced back to September’s Prime Minister’s reshuffle, which saw the care sector presented with a completely new-look ministerial line-up; Burstow was replaced by fellow Lib Dem Norman Lamb, while Health Secretary Andrew Lansley was also replaced in favour of Conservative Jeremy Hunt.

The new ministers have the task of overseeing the care reforms announced in July’s Care and Support White Paper, but Burstow was not content to leave quietly. Writing in The Daily Telegraph, the minister for Sutton and Cheam raised both the Treasury’s commitment to answering the long-term funding issue – a notable absence from the reforms announced by Lansley in July – and also the ability of Prime Minster David Cameron and Deputy Prime Minister Nick Clegg in being able to influence Chancellor George Osborne.

Burstow writes: “In July the White Paper I drafted was published. It tackles much that is wrong with care. Widely welcomed, it offered a vision of a better more compassionate care system. But the plan left unanswered the issue that makes so many people feel angry and let down, who pays for care?”

Exploring the previous Labour Government’s failure to tackle the funding issue, Burstow asks “could the Coalition fail too?” and, confirming what care professionals have feared, states that the answer lies with HM Treasury.

“The Treasury’s view is simple: kick the can down the road despite our rising elderly population. There's no sense of urgency. No recognition that left unreformed there is no incentive for families to plan and prepare.”

The former minister concludes by challenging the two party leaders: “The question now is will David Cameron and Nick Clegg take on the Treasury orthodoxy and deliver a fair funding system that gives every family in this country peace of mind?”

A cap on individual care costs remains the key aspect of reform the care industry desires a solution for, as was shown by the response of leading sector organisations when finding it absent from the White Paper. The English Community Care Association’s chief executive, Martin Green, responded “we cannot hide our disappointment that the issue of funding has not been clearly resolved”, while CEO of Anchor, Jane Ashcroft, said that the Government needed to “accept the realities of demographic change”.

Managing director of Prestige Nursing + Care, Jonathan Bruce, is among those who share Burstow’s anxieties, commenting:

“The Treasury blocking funding for elderly care could have disastrous consequences. The vast majority of people make no financial provision for the cost of elderly care. This, combined with the rising rates of care homes, means NHS beds will continue to be taken by elderly people who could be treated elsewhere leading to greater financial outlay for the Treasury in the long run.

“Failing to implement a cap on care would be a leap away from improving the social services system. With circumstances looking set to worsen, the coalition needs to make its move on care before it’s too late.”

Head of policy at the Alzheimer’s Society, George McNamara, further highlights the problem: “Millions of people, including tens of thousands of people with dementia, are currently having their savings obliterated by the costs of essential care. These same people were left disappointed by the absence of real answers in this summer’s white paper. Like Mr Burstow says, this issue has been fudged for too long. We need strong political leadership to transform the lives of people with dementia for the better.

“Removing the financial burden of social care from the shoulders of people with the condition and agreeing on a sustainable way of funding the system has to be a priority.”

A report ‘Papering Over Cracks’ released by the NHS Confederation last week has warned against any use of NHS funds as a solution, a key point being that: “The NHS already needs to deliver an unprecedented level of efficiency savings with a budget which is essentially flat. To increase NHS efficiency savings by at least £2 billion a year on top of the Government's existing requirement to save £4 to £5 billion a year will not be possible without severely affecting patient care. We are calling for a cross-party consensus on solving the challenges raised.”

New Care Services Minister Norman Lamb would appear to agree with this, confirming at the Liberal Democrat party conference, in Brighton this week, that “you can’t fund care reform from existing resources because they are under intense strain”, suggesting that voices both outside and inside of Government are heading for a collision with the Treasury as the Spending Review looms in the Spring.

All this comes despite unsubstantial reports in August that the Prime Minister was “confident” that funds would be found to support the Dilnot Commission recommendations, although it was also rumoured he would not look to implement fully until after the next election in 2015.

Labour’s shadow social care minister Liz Kendall, speaking to the Labour Conference in Manchester yesterday, spoke of the party’s need to appeal to voters by addressing the issue of ‘wasteful spending’, saying: “Even before the financial crash our NHS and care services needed to change to meet the health challenges of today and tomorrow. The fundamental problem is that our health and care system was created in a very different age."