Peers call for free personal care, £8bn and a social care white paper to end 'national scandal'

£8 billion must be ‘spent immediately’ by the government on England’s adult social care and free personal care should be available to everyone, a House of Lords Committee has recommended.

Free personal care in England should be available universally by 2025/6 and funded through general taxation over a period of five years, concludes the House of Lords Economic Affairs Committee’s report ‘Social care funding: time to end a national scandal’.

Forget the green paper, publish a white paper now

The Committee's report, published today, also recommended the government not focus on a green paper for social care and publish a white paper immediately.

Lord Forsyth of Drumlean, chairman of the Economic Affairs Committee, said: “Fixing underfunding is not difficult. The Government needs to spend £8 billion now to return quality and access in the system to an acceptable standard.

“Fixing unfairness is more complicated but the Government has ducked the question for too long. They need to publish a white paper, not a green paper, with clear proposals for change now.

“We think that change should include the introduction of free personal care, ensuring those with critical needs can receive help with essential daily activities like washing, dressing and cooking.”

Lord Drumlean also noted the unfairness of someone with dementia paying hundreds of thousands of pounds for care, while someone with cancer gets care for free.

Cap on accommodation costs

If the Committee’s free personal care proposal were implemented, people living in care homes would still pay for their accommodation and assistance with less critical needs.

Those receiving care in their own homes would not have to pay accommodation costs, which the Committee felt may encourage care users to seek essential help with personal care early.

The Health Foundation and the King’s Fund estimate this would cost £7 billion if introduced in 2020/21.

The report also recommended the government retain a means test for accommodation costs and to avoid catastrophic accommodation costs, the government should also explore a cap.

Social system ‘riddled with unfairness’

Lord Drumlean added: “Social care is severely underfunded. The whole system is riddled with unfairness.”

The report found more than a million adults who need social care aren't receiving it, family and friends are under pressure to provide unpaid care and the care workforce continues to be underpaid and undervalued.

The Committee heard evidence that local authorities are increasingly expected to fund social care themselves, despite differences in local care demands and budgets.

Funding is £700 million lower than 2010/11 in real terms, despite continuing increases in the numbers of people who need care. The Health Foundation and The King’s Fund estimate that to return access to social care to 2009/10 levels, the government would need to spend £8 billion.

The Committee also heard how local authorities can’t afford to pay care providers a fair price, forcing providers to choose whether to market to those people who fund their own care or risk going bankrupt.

Peers reject mandatory social care insurance system

The Committee believes currently establishing a market for long term social care insurance in England 'would be difficult', even with a cap on lifetime social care costs or accommodation costs or an auto-enrolment scheme.

The report stated: 'We do not support the introduction of a hypothecated tax or a mandatory social insurance system. While some witnesses said that this could help the public trust that extra taxation will be spent on social care, hypothecation could leave the amount of funding available more sensitive to the performance of the economy.

'Private insurance cannot provide the amount of funding required by the social care system, not least because roughly half of public social care funding is currently spent on people who are working-age.'

In 2016/17 local authorities spent £18.15 billion on adult social care, which was divided equally between care for older people and for those of working-age.

The report also recommended that people older than the state pension age should no longer be exempt from employees’ national insurance but should pay the same rate as other age groups. The Committee believe this measure could raise more than £1 billion.

Peers recommended extra funding for social care should come from national government which should raise the money largely from general taxation, with the money distributed to local authorities.

Extra funding needed for social care should be given as a government grant directly to local authorities, according to a national funding formula and the amount would consider differences between local authorities in demand for care and ability to raise funds from local taxation.

Message for the new PM

Sally Warren, director of policy at The King’s Fund said: "This report, from an influential cross-party group which includes two former Chancellors, makes a strong case for immediate, additional public investment in social care.

"In the longer-term the case for change is overwhelming, and we welcome the Committee’s call to move towards a more generous system which would give more people access to publicly-funded social care as a useful contribution to the public debate. "Reforming social care is now one of the most urgent and important social policy issue facing the country and should be at the top of the agenda for the new Prime Minister."

Vic Rayner, executive director of the National Care Forum said: "The message is clear for the future Prime Minister – adult social care is domestic priority number one – and the combined voices of local government, providers of care and the workforce, members of the House of Lords, parliamentarians from across the parties and people receiving care and support and their carers demand action now.

“To take no immediate action in the face of this evidence as a new Prime Minister will not serve this country well.”