Long-term care: why the system is close to breaking point
We explain who is entitled to state help, and why experts think the system needs to be reformed.
3:55PM GMT 03 Jan 2012
Hundreds of thousands of elderly people are at risk of “terrible abuse and neglect” through the failings of Britain’s care system, experts stated in a letter published in The Telegraph.
What can those approaching the age when care may be needed, or who have relatives in this situation do about funding long term care? The following answers may help to shed some light.
Q. What are people saying is the problem with the long-term care system?
A. Experts including members of Age UK, the British Medical Association and Carers UK signed a letter in the Telegraph backing proposals that no one should pay more than £35,000 for care bills in their lifetime. They said around 800,000 pensioners were being left without basic care, and thousands were forced to use up their savings and sell their homes to meet care bills.
Q. What do they want to do about it?
A. These experts are backing proposals from Andrew Dilnot, who published a report into the funding of long-term care in the summer. He prop proposed that those with assets of less than £100,000 should not pay fees at all, and that those who are liable to pay should have costs capped at £35,000.
But these proposals could proved costly for a cash-strapped Treasury – and it seems unlikely any change will happen before 2014, if at all. The letter calls on Mr Cameron to secure cross-party support for lasting reform of the care system – claiming that otherwise it will continue to condemn pensioners to “a life of loneliness”.
Q. Sounds like these people think the system is working very badly. How do people finance care at present?
A. Many families end up paying for care at present, as those with assets of more than £23,250 will not get help towards care costs. Those with savings of under £13,000 get free care. Between £13,000 and £23,250 individuals have to contribute to the costs. In most cases, this figure will include the family home. But there are circumstances in which it is disregarded – the most important being if a spouse, partner or relative aged 60 or over is living there.
Likewise, the home should not be included if care needs are “temporary”. These rules apply to those living in England. In Scotland, the threshold is broadly similar, although people also get a contribution towards personal care. Wales and Northern Ireland currently have a similar system to the rest of the UK, although both are likely to meet personal care costs in the future.
Q. How do I go about sorting out care costs under the current system?
A. Start with a health assessment. Anyone needing care, whether in a nursing home or in their own home, needs to have their needs assessed by their local authority. This needs to be done before any financial assessment is made.
Once you have the result of the assessment, the local authority will give you a maximum figure they will pay per week towards the care needed. This figure is based on medical needs. Each council sets its own threshold for how incapacitated you must be to be eligible for help.
At this point you need a financial assessment to see if the person has to contribute. If health needs are particularly acute you may qualify for NHS continuing care. This means all care costs – including residential care costs – will be met by the NHS, rather than the local authority. Families can ask to be reassessed for NHS continuing care if their relative’s health deteriorates.
Q. What is happening now with regard to changing the rules? Does the Government have to adopt the new proposals?
A. No. Many fear that the £35,000 cap proposed by Dilnot will not happen, because it is too expensive. Health secretary Andrew Lansley, Lib Dem health minister Paul Burstow and shadow health secretary Andy Burnham are expected to hold the first in a series of meetings within the next few weeks. Ministers say that plans to reform social care will be put forward in the spring.
