6. There are two big reasons people get refused care funding, and the proposals ignore one of them
Even if you pass the now more generous means test, the councils that administer social care can still deny you support if they judge your care needs to be ‘too low’.
And cash-strapped local councils are applying means tests ever more stringently. The “needs threshold” is set “far too high”, economist Andrew Dilnot told the ‘Today’ programme yesterday. You might be unable to cook for yourself, or leave the house, and still find yourself refused social care funding, regardless of your financial situation.
That’s one of the reasons the numbers actually receiving care funding have been going down, even though more adults than ever – an increase of 120,000 over the last five years – apply for it. In the financial year 2019-2020, only half of the 1.37 million older adults who applied for social care funding received any, and not all of what was awarded was long term.
7. Privatised social care has seen huge sums extracted by the money men
Following the privatisations of the late 1980s, 95% of elderly care home beds are now provided by private firms. The care home and care agency market is riven with collapses, insolvencies and buyouts, which increases the uncertainty for users and relatives, and the risk that people will be forced to move to care homes far away from their families, or stuck in failing homes.
The big care home providers tell us that the only issue is underfunding, and that they’ve been impoverished by the rise in minimum wage and cuts to local authority payments. But they tend to operate a distinct business model, which loads costs on to the parts of their group located in the UK, which never seem to make a taxable profit, even as related companies in their network – often located in tax havens – extract high rents, interest payments, management and consultancy fees, and dividends for shareholders. According to the Centre for Health and the Public Interest, this model means at least £1.5bn a year is leaking out from the large care home providers. Take HC-One, which operates through an extensive network of companies including several registered offshore in the Cayman Islands or Jersey. HC-One has reported a loss every year bar one since it was set up in 2011. It has never paid corporation tax, but still paid out at least £48m in dividends between 2017 and 2018 alone.
8. The reforms don’t even protect the wealth in people’s homes
Still, at least “no-one will have to sell their home to pay for care costs”, right? Well… the reforms don’t kick in for another two years. And even then, as well as the need to still raise the first £86,000 of care costs (if you own a home worth more than £100,000), there’s one more loophole. You’ll also have to pay for the accommodation element of residential care – only personal care costs will be covered by the cap.
9. Yet another policy fudge
More importantly, though, the fundamental problems of access and quality will remain, even when the plans do start to kick in in two years’ time. Even if you do pass the twin hurdles of means-testing and ‘needs’ eligibility, and get some social care funding, soaring costs that rise above inflation and still-squeezed council budgets mean that you may be offered home visits that are too brief and infrequent, or a cheaper, inadequately-staffed care home.
So even if you have little money and a high level of need, you may still have to pay out of your own pocket for some, if not all, of the social care you require. If you can find the money, and are able to navigate the complex marketplace, that is. Otherwise, you’ll have to either rely on friends and relatives, or go without essential personal care needs being met, as 1.5 million older adults and many disabled people currently do. Natasha Curry of the Nuffield Trust think tank said that Johnson’s announcements meant “the broken social care sector will be feeling short-changed and bitterly disappointed”.
Johnson has also promised yet another social care white paper at a future date, despite the fact that we’ve had 12 consultations and five reviews in the last 20 years. But it’s a bit strange to promise to reform social care only after the government has “integrated” the still means-tested, loophole-ridden, privatised care system, with the NHS. That’s what the Health and Care Bill, which is already before parliament, sets out to do.
Despite the announced plans, the quality of care provided will still be relative to a person’s ability to pay for it. We don’t accept this in healthcare, or at least, we haven’t in the past. So, why should we accept it for
social care?
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9 reasons Johnson's plans don't fix social care - Open Democracy
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