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Care: Costs Cap

Volume 764: debated on Monday 14 September 2015


Asked by

To ask Her Majesty’s Government what assessment they have made of the impact on patients, residents of care homes and their families and carers, of the decision to postpone the introduction of the cap on care costs from April 2016 until April 2020.

My Lords, the decision to delay implementation of the cap on care costs followed careful consideration of feedback from stakeholders, and it was felt that April 2016 was not the right time to implement these significant and expensive reforms. I stress that we remain committed to these important reforms, which offer financial protection and peace of mind. We have had to make hard choices, balancing the benefits of the cap against the need to focus on supporting the system that supports our most vulnerable.

I thank the Minister for that response. The Government’s election manifesto said that capping the amount patients can be charged for residential care from 2016 would give,

“everyone the peace of mind that they will get the care they need and that they will be protected from unlimited costs if they develop very serious care needs—such as dementia”.

The assessment of one of the key stakeholders, the Alzheimer’s Society, is that the delay until 2020 will cause unacceptable costs to continue to be borne by people with dementia in their families. These are people particularly affected by the cost divide between social care and NHS continuing care. What actions will the Government be taking in the lifetime of this Parliament to meet their commitment to this key group?

This is a very important group at a most vulnerable time in their lives. The Government remain fully committed to introducing the cap on social care costs and helping people to cope with the potentially high costs of social care. It is not cancelled and will be brought in by 2020, but until then means-tested financial support remains available to those who cannot afford to pay for care to meet their eligible needs. Where a person can afford to pay for their care, we are clear they should not be forced to sell their home during their lifetime to do so. Since April this year, deferred payments have been available across England for people with less than £23,250 in liquid assets who might otherwise face that risk. By entering into a deferred payment agreement, a person can defer or delay paying the costs of their care and support until later, including out of their estate if they choose.

My Lords, is the Minister aware that for many families, the postponement of the cap on care costs is seen as a betrayal that is adding to their disillusionment about the persistent underfunding of social care? Surely the Government must understand that families who look after people—for example, someone with Alzheimer’s—cannot go on taking these responsibilities if promises are broken and if the support they need is either non-existent or too expensive. Will this problem not exacerbate the Government’s existing problem with delayed discharges if families are in future less willing to take on caring, and is the Minister concerned about the delayed discharges issue?

This is indeed a concern, but I must emphasise that this delay is not a decision that has been taken lightly. A letter from the Local Government Association dated 1 July was clear that we need to think carefully about all the options, including postponing new initiatives. Therefore, we will make further announcements and they will follow in due course. Furthermore, we will continue with other efforts to support social care, in particular through the better care fund, which will drive the integration of social care and the NHS.

My Lords, when the care cap was postponed, the duty on local authorities to assess and meet the eligible care needs of self-funders was also postponed. There are about 460,000 of them. Last April, the department sent a letter to local authorities advising them on how to prepare for assessing self-funders. They have been given £146 million to carry out early assessments starting this October, which will cover about 50% of those self-funders. As the postponement is now planned, will the Minister tell us whether this money has been handed over and what will happen to self-funders who will now remain outside local care eligibility assessment and the advice system for another five years?

Indeed, £146 million was allocated to support local authorities to prepare for implementation of the cap in April next year. It is likely that money spent to date on preparing for the reforms will have wider benefits in terms of improving local authorities’ systems and their understanding of their self-funding population. This is important because local authorities have a number of population-wide duties under the Care Act 2014, for example, the duty to provide information and advice services to facilitate a vibrant and diverse—

It is not too long. It is difficult to answer the question properly without saying something and this is very important. We are going to support high-quality care for the benefit of the whole local population.

My Lords, as questioners have illustrated to your Lordships’ House, we face a perfect storm with health and social care. There was cross-party agreement in advance of the 2010 election that the cap was vital. We have delayed discharges and local authorities facing a real crisis. Will the Government take action in the next few weeks to remedy this problem, of which the cap is an important part?

As I said, means-tested financial support remains available for those who cannot afford to pay for care to meet their eligible needs, but the introduction of the cap on care costs system will be the biggest reform to how care is paid for since 1948 and we must ensure that the new system works from day one. Local authorities and partners have consistently warned us of the risks of implementing this too quickly. We will therefore not be complacent and will work hard to make sure that there is additional time to ensure that everyone is ready to introduce the new system and that people can understand what it will mean for them.