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Social Care: Funding

Volume 742: debated on Monday 21 January 2013


Asked By

To ask Her Majesty’s Government when they will announce their decision on the Dilnot Commission’s recommendations on capping the cost of adult social care for individuals.

My Lords, the Prime Minister and Deputy Prime Minister have committed to announcing further details before the Budget on capping the potentially huge costs of long-term care, giving people the certainty that they need to plan for their long-term care needs. The Government have agreed the principles set out by the Dilnot commission. We expect further details shortly.

My Lords, I am grateful to the Minister for that reply. Progress is being made, albeit a little slower than many of us would like. Will the Government prepare draft clauses on a capping system for consideration alongside the draft Care and Support Bill? Does he agree that, to work effectively and fairly, national capping of individual liability will require the draft Bill to provide for portable national eligibility criteria?

My Lords, as the noble Lord is aware, the draft Care and Support Bill is currently going through pre-legislative scrutiny. Our proposals can be amended to support the cap in law and we would include the appropriate provisions when legislation is introduced. I can tell the noble Lord that work is going on drafting such clauses. We have said that we will build national eligibility criteria into the Bill.

My Lords, from what we read in the press, it looks as if the Government’s plans might include a cap of £75,000 and that that will not include accommodation costs. As I understand that 85% of people incur lifetime costs below £75,000, would this not skew the outcomes unfairly?

My Lords, we have to speak speculatively and hypothetically because I cannot give the noble Baroness any indication of the level at which the Government will finally propose to set the cap. The level of the cap needs to represent an affordable and sustainable relationship between the state and the individual. We will give due regard to the Dilnot recommendations for the cap while taking into account current economic circumstances. We will set out further details in the coming weeks but I am sure that the point that the noble Baroness effectively makes will be closely borne in mind as we approach decision time.

My Lords, with more people needing social care, and with a higher cap than anticipated under Dilnot being probable, what provisions are being made to assist local authorities to cope with managing deferred payments for care?

My Lords, as my noble friend is aware, the universal deferred payments scheme will be part of the Care and Support Bill. No doubt, we will debate those provisions when the Bill comes before us. I cannot tell her when that will be, but, clearly, they will be the subject of close scrutiny by the Joint Committee.

My Lords, is not one of the unfortunate effects of the Dilnot proposals that they protect inherited wealth at a time when the NHS needs money?

My Lords, the main benefit of the Dilnot proposals is to protect people from unpredictable and catastrophic costs of long-term care. While the noble Lord could interpret the raising of the means test as a way of protecting the rich, I see the combination of the cap and the threshold as a way of giving greater certainty and predictability for all concerned, because none of us, whether we are rich or less rich, can know whether we will be subject to catastrophic care costs at a later stage in our lives. That is the inherent unfairness which Dilnot and the rest of the commission attempted to address.

My Lords, following on from that answer, does the Minister accept that uncertainty is the most difficult thing for vulnerable people and their families to cope with? They are uncertain about the level of services that they will have because of problems with local authority budgets and they are absolutely uncertain about what their financial liability will be. Therefore, saying that the Government will accept the Dilnot proposals but not saying when or at what level is only adding to that uncertainty in a most unacceptable way.

My Lords, I might have hoped that the noble Baroness would welcome my initial Answer, which at least gives her the certainty that an announcement will be made before the Budget. As the noble Lord, Lord Warner, said, that is progress and, I hope, welcome progress. However, I take the point that the noble Baroness makes and the sooner we can introduce the certainty that she desires the better.

My Lords, first, is it possible that these clauses will be available during the time that the Joint Committee is still working? Secondly, am I right in thinking that Dilnot has nothing to do with healthcare but has to do with what we usually call social care?

Yes, my Lords, my noble and learned friend is right. The Dilnot proposals focus primarily on social care although there are always knock-on effects for the health service. In theory, it will be possible for us to produce clauses covering the Dilnot proposals for scrutiny by the Joint Committee but I am not in a position to give that undertaking at present.

My Lords, I welcome the announcement that has been made and I hope that it will please more of us than seems to be the case at the moment. We shall see. Does the Minister agree that the effectiveness of the Dilnot proposals for a cap depends on adequate insurance products being available to cover pre-care costs or costs that arise before that cap is reached? If so, have the Government had any discussions with the insurance industry or are any planned?

My department is engaging actively with the financial services sector for the very reasons that the noble Lord suggests. As I have said, care needs are very difficult to predict and care costs can be open-ended in the current social care system. At the moment, that makes financial products very expensive to buy and difficult to develop. There are many reasons why people do not consider financial products for their care at present, including a lack of awareness that they have to pay. We very much hope that the introduction of a Dilnot-type solution to this problem will encourage the financial services sector to develop these products and we believe that that will happen.