YES: Jane Ashcroft, Acting chief executive, Anchor Trust
Older people’s housing and care is one of the most pressing issues facing today’s society. The number of people aged 85 and over is rocketing faster than any age group in the UK amid predictions that there will be 15 million over the age of 65 by 2030.
Alongside this demographic shift, expectations of this age group are changing. The “baby boom generation” is nearing retirement and they are rightly demanding their quality of life is at least maintained, if not improved as they age. They have high expectations and are demanding better services — and they are right to do so.
As England’s largest not-for-profit provider of retirement housing and care homes, we welcome the recent Green Paper that begins to set a vision for a new care and support system. The time is right for radical reform and there needs to be an honest debate about the standards of care that are acceptable in the 21st century, the true cost of delivering this care and who should pay for it.
We know that older people, like anyone else, want a community to thrive in and this demand will increase over the coming years. While the ideal would be a tax-funded approach, free at the point of delivery and covering all the costs, it would place a too-heavy burden on the working population.
Advertisement
Even if the state contributed no more to older people’s care than it does currently we would need an extra £14 billion each year by 2026 to aid the growing older population. Seeking to deliver the desired quality of life would cost much more and there is no indication the taxpayer has the appetite to cover the increase. Would this same debate be held if we were talking about children’s social care? Anchor’s favoured model is a partnership approach where the cost of care in old age is shared between state and individual, with insurance and equity release options key mechanisms in a funding model of the future. Under this approach, the Government predicts that a 65-year-old in England, who will typically require care and support that costs on average £30,000 during their retirement, might need to pay about £20,000.
The amount people pay will vary but overall everyone needs to understand the true cost of their care and recognise their role in funding it. And in order to achieve this, a massive education campaign would be needed to shift the current attitudes to planning for care in old age.
The fact that we are living longer and seeking to improve our quality of life places new responsibilities on the State, on individuals and providers of housing, care and support services. Delivering the flexibility, choice and quality of care older people will expect in the future cannot and should not be shouldered by the State alone.
NO: Peter Beresford, Professor of social policy, Brunel University
Our social care system, by common consent, is untenable. It is unfair and inequitable and it doesn’t work. Most people have completely wrong assumptions on social care: they think they are going to get it free like healthcare. In fact, it is means and needs tested. Increasingly, people on middle incomes or whose needs are not extreme enough fall through the cracks.
Advertisement
The idea of a national care service is excellent. An older person should expect the same care wherever they are. At present people don’t move because they are afraid of losing their support.
The problem is who should pay. The proposals for paying for this system — private insurance or a £20,000 lump sum — will not work. A private insurance system is not going to deliver the service for all: look at pensions or the US heath insurance model.
These are serious amounts of money. Older people are already going to face difficulties with pension costs and so on. The temptation for people will be simply to sit tight and hope it doesn’t happen to them. What’s more, the costs outlined in the Green Paper were not presented realistically. Accommodation, about 40 per cent of social care costs, will not be covered. The true amount to be paid will be far higher. Older people are the largest group of social care users, but other groups — disabled people, people with learning difficulties, those with chronic conditions, for example — have been largely overlooked.
Despite trying to encourage debate, the Government has ignored the obvious model to pay for a national care service — general taxation.
We carried out a consultation for the Joseph Rowntree Foundation with a wide range of social care users. They identified a real fear on the part of Government and the Opposition of saying “you might have to pay more tax”. Charities have gone along with the idea that older people should pay for their care because they are afraid to bring up the idea of tax.
Advertisement
Social care is already, to a serious extent, being paid for by taxes: through council tax. The idea that only those who are at risk of needing care should pay for it is inequitable and unlikely to ensure good care for everybody. If we are all paying, it has to be cheaper.
For a long time the Government’s mantra has been integration of health and social care. It is impossible to integrate two systems where one is means-tested and the other free.
It saddens me that older people are thought of as a burden. They contribute to society in all sorts of ways — volunteering and much more.
For governments to say to people who have worked their whole lives: “tough luck, there are too many of you for us to look after” is not civilised. If the Government made the case for taxation clear, it really could work.