Cordis Pulse: May 2017
30 May 2017
This month, we have conducted a review of the party manifestos for the 2017 General Election and what they potentially mean for adult social care and health and for children and young people’s services. Please see more in the news section.
A positive is the increased focus on adult social care. In the 2015 General Election, adult social care barely got a mention. The Conservative manifesto commitment to implement the higher threshold for means testing and the introduction of a cap on the total cost of care were both postponed eleven weeks after the election. Now the Conservatives have put forward another scheme which is the effective abolition of free or subsidised homecare for anyone who owns a property in England. We can find only four areas of the country where the average value of a home is less than £100,000. Following a poor reception for this idea the Conservatives have reversed their position on a cap on the lifetime costs of care and suggested that consultation on this would form part of the process of developing a green paper.
As a strategy it is probably right to look to an income raising measure to pay for it, but the brevity of the manifesto combined with the further alterations to the policy raise many more questions than answers, chief amongst these are:
- The level of the cap is critical. The original plan of having a cap on the cost of care set at £72,000 meant in practice that very few people entering residential care would ever live long enough to reach this amount.
- Equity release is a complex area and there is a significant cost difference between Universal Differed Payment (UDP) schemes operated by local authorities and the products available in the private sector.
- The UDP scheme is already patchy in application and it is far from clear that Local Authorities could manage a significantly extended scheme in both scale of resources and duration of loans.
One of the possible unintended consequences of this policy change could be a growth in residential care. Under the current system the value of an asset plays no part in determining what an individual pays for home care but does for residential, remove this anomaly and suddenly residential care can become a more attractive option for families to consider.
All parties in this election have attempted to say something of substance about the provision of adult social care and for all of them the harsh reality is that with an aging population the demand for these services will rise and with them the cost.
The dilemma is really about who takes responsibility, the individual alone, the collective via the state, or a combination of the two.
Concerning Children’s Services we were pleased to see the findings of the evaluation of Birmingham City Council’s Step Down programme. This evaluation conducted by the Rees Centre at the University of Oxford shows the impact of a partnership approach to bringing young people out of residential homes into foster placements. It suggests the approach in Birmingham has achieved both potential cost savings as well as positive impacts on placement stability and young people engaging in much higher levels of activities than they were in their prior residential placements. These findings link to our work supporting a number of areas to improve their approaches to foster and residential care for children and young people.