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Social Care FUNDING : GREEN Or RED HERRING PAPER ? Various Schemes And Utter Madness : All Together In This Thread - Page 4 - Carers UK Forum

Social Care FUNDING : GREEN Or RED HERRING PAPER ? Various Schemes And Utter Madness : All Together In This Thread

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179 posts
Busy morning ... already a counter argument against a Carer ISA ... and still based on the ability to pay !

https://www.theguardian.com/society/201 ... ttee-chair

Government's 'care Isa' plan dismissed by Tory health committee chair.

Dr Sarah Wollaston labels as ‘colossal mistake’ proposed Isa where inheritance tax is axed.

A senior Tory MP has dismissed proposals for a “care Isa” after it emerged that ministers are considering a tax-free personal savings scheme to cover the rising costs of caring for an ageing population.

Dr Sarah Wollaston, who chairs the Commons health and social care select committee, said plans for a social care Isa were “a colossal mistake”, adding that it would only serve as a solution “for a small minority of wealthy people”.

The policy proposal for the new Isa, to be outlined in the government’s upcoming social care green paper, would allow any unspent funds in the Isa after death to be passed on, tax free, to the holder’s family.

At present, when an individual dies, any money left in an Isa investment is automatically rolled into their remaining estate which is subject to the inheritance tax rate of 40%.

By axing inheritance tax on the accounts ministers hope that it would encourage pensioners to hold on to their savings into old age, when they are more likely to need to pay for nursing homes and round-the-clock care.

But Wollaston dismissed the plans, revealed in the Sunday Telegraph, as little more than a way to help the well-off pay for their care needs.

Tweeting her frustration at the proposals, the Tory MP for Totness said: “This won’t solve the care crisis at all. There is no pooling of risk. It only ‘solves’ it for a small minority of wealthy people who can afford to invest and whose families benefit from paying lower tax on their inheritance if not used for care.”

She added: “Abandoning the centre ground & the will to tackle inequality is a colossal mistake.”

Ros Altmann, the Conservative peer and former pensions minister, said the current tax rules around Isas give people a “perverse incentive” to spend their savings before they fall into ill health.

After gathering figures that showed that more than 12 million over-50s have saved tens of thousands of pounds into Isas, Lady Altmann told the Sunday Telegraph: “As these figures are an average, many will have much more saved, which could usefully contribute towards their future care needs – unless they have spent it all by the time they reach later life.

“If you haven’t spent your Isas before you pass away, the money will go into your estate and could be taxed at potentially 40% – so if you have large sums in Isas, there is the perverse incentive to spend them before you die.

“There is a real danger that those who have set aside these savings will really regret not having kept it for possible care needs when older.

“The majority of people do not realise the NHS will not be able to pay for their care.”

Figures obtained by the paper show that more than 4.3 million people over the age of 70 have an average of £40,000 in Isas.

However, Wollaston is urging the Treasury to look again at recommendations made by the select committee on how to manage the social care budget.

Pointing out that the tax-free Isa scheme would only boost the care provision for the wealthy she called for ministers to consider proposals outlined in the report drawn up jointly by the health committee and the housing, communities and local government committee.

The committees concludedthat “an earmarked contribution, described as a ‘social care premium’, should be introduced, to which individuals and employers should contribute.

“This can either be as an addition to national insurance, or through a separate mechanism similar to the German model.

“The social care premium could be managed by central government, and audited by the National Audit Office, or managed separately by a statutory body or not for profit insurance based funds, as is the case in Germany.”

A Department of Health and Social Care spokesman said: “Our green paper due in the autumn will set out our plans to reform the social care system to ensure it’s sustainable for the future.

“In developing the green paper we are looking at how we can support people with the costs of their care in a way that is fair to all generations.”

Let 'em propose ... and counter propose.

NOT ONE has addressed the REAL issue ... basing social care on the ability to pay.

You know the rest ... by now ?

If not , where have you been ?
Much welcomed article in this morning's Guardian ... Age UK , once again , leading the way :

https://www.independent.co.uk/news/uk/p ... 12051.html

England 'left behind' in race to resolve social care funding problems, charity warns.

Despite government consultations, official commissions, green and white papers and an act of parliament, England's system of means-tested care funding is broadly unchanged, Age UK says.
England has been “left behind in the race” to resolve its social care funding problems, a charity has warned.

Age UK said an entire generation of elderly people had “lost out” after various proposed care reforms had been left to “gather dust”.

The comments came after a new report compared social care systems across the UK, Germany, France, Spain, Italy and Japan.

While the authors said they did not find a “magic bullet” solution – every country is facing some problems – they concluded England comes across “rather badly” compared with other systems.

The report, conducted by Incisive Health on behalf of Age UK, states that no government “is yet to really grip the issues”.

Age UK said despite two government consultations, two official commissions, five green or white papers and one act of parliament, England’s system of means-tested care funding is broadly unchanged.

The authors of the report highlight that people with care needs in the countries compared get a more generous financial deal than those in England – where anyone with savings or assets above £23,250 has to pay all the costs of their long-term care.

Other countries generally either provide some non-means-tested basic level of support, and/or cap the amount of co-payment to be made, and/or use a more gradual means-test, the report adds.

“Sadly, this new report shows that England has been left behind in the race to update the funding of care for older people, compared to some other similar nations,” said Age UK’s charity director, Caroline Abrahams.

“As a result, our older people and their families are paying more and bearing a lot more of the risk of needing expensive long-term care.

“The reality is that an entire generation of older people in England has lost out, given that Germany embarked on care funding reforms in 1995 and Japan in 2000. Here, we have had to make do with a succession of consultations gathering dust.

“It is crucial that the forthcoming social care green paper isn’t yet another failed exercise.

“The evidence from other countries is that a package of measures that significantly improve the care offer to older people attracts a lot more public support than something more timid – the public isn’t stupid and will demand good value in return for paying more.”

Commenting on the analysis, James Jamieson, vice chairman of the Local Government Association, said: “Adult social care is at breaking point due to years of underfunding, rising demand and costs for care and support.

He said council taxpayers “cannot bear the costs of solving this crisis on their own” and that there is a “pressing need” to bridge a £3.5bn funding gap facing adult social care by 2025 just to maintain existing standards of care.

A Department of Health and Social Care spokesman said: “We have provided local authorities access to £9.4bn in dedicated social care funding over the last three years.

A radical solution IS needed.

1. Return social care to the NHS.

2. Gradually convert NHS facilities to accomodate nursing homes ... a factory if you like ... all facilities in one complex.

3. Fund through GENERAL taxation ... like the NHS is now ... NHS is free / social care is means tested !

( When leaving hospital , are you presented with a bill for social care administered whilst you were a patient ??? )

4. Treat dementia the same as cancer for cost purposes ... no more " Discrimination " in treating illnesses.

Radical ?

Or just plain common sense ???
Re (4). Trouble is, dementia care costs £100 a day (minimum charged by care homes) Does cancer care cost that much? Plus, terminal cancer patients die a lot faster than dementia patients. Average lifespan post-dementia diagnosis is 6-8 years. That's around £300,000.
Costings quoted are based on the present system.

Costs for treating illnesses ?

Cost is NOT the problem ... charging for some and not for others ... discrimination ... is the problem.

A political decision , NOT a medical one.

Again , a cancer patient suffering dementia ?

How many agencies involved with his / her care ?

Under the present system , the level of care depends on that patient's ability to pay.

Is a cancer patient faced with the same dilemma ?

" Only ten minutes of therapy today squire. A bit short in the reddies this week. "

A number cruncher to record what's free and what needs to be charged ?

Under my suggested system ?
Cost IS the problem!

Whether the NHS pays, or local councils pay, or Social Service pay, the cost of dementia care is STILL going to be £100 a day for residential care (and around what, £20 an hour for care calls?)

For the taxpayers, it really doesn't matter whether tax money is funnelled down the NHS, or local councils, or SS etc.

Grimly, cancer care IS cheaper - as I say, terminal patients are usually left to die as quickly as possible, because the only alternative is the NHS forking out vast sums on expensive life-extending drugs (my husband was on one that cost £70 a day - the cost of each pill he took - I worked it out.....'luckily' for the NHS he died pretty quickly anyway. Phew, relief!)(to them...)

The problem for the NHS with dementia, however, is that it is a 'slow killer' - folk just don't die quickly enough with it....
Hence the political decision to first break the link between the NHS and social care decades ago ... followed by a whole mismash of policies that have done nothing to address the real issue of a rising , elderly , population over the 50 years.

Questions like that were common place in exams in the 1960s / early 1970s.

Strange ... how Japan were the first major economy to recognise the problem , then took measures and still , they have one of the worst , acute , problems in the advanced economy countries.

The longer the two remain divorded , the deeper , and more costly , will the measures be in order for the Government , of whichever flavour , to restore a coordinated system built for the UK population which can be seen to be fair ... and affordable as well as work efficiently ... for all ... and not just those with the ability to pay.

Cannot be done with different agencies / laws / funding systems ... cancer patient suffering dementia analogy again.

As social care stands today , BOTH high and low earners see injustices ... a real novelty ... and almost a first in my lifetime.

Perhaps some readers would prefer the American type system ?

The forthcoming Green Paper on social care will make very interesting reading ... a further switch to the ability to pay probably the favourite as the riders get ready to leave the paddock ?

A rerun of a decade ago ... CarerWatch days ... and our objections to the concept of Direct Payments ?
Totally agree that dividing the budget (however inadequate it is!) between social care and medical care is just wasteful and inefficient.

And it would certainly 'force the issue' for dementia to be regarded for what it is - ie, a medical problem.

The division also, of course, allows endless 'buck passing' between SS and the NHS - again, to the detriment of the patient themselves.

Interesting what you say about Japan - how bad is the situation there?

As for the USA, I mean, what DO folk who haven't got medical insurance up to the eyeballs (and I think it runs to the millions and millions and millions) actually DO when their parents get dementia? Is it just family care only??
For the UK, the funding problem (ie, funded through taxation of some kind, whether it's NI or direct/indirect tax revenues etc etc etc) is complicated, because so so difficult to get accurate forecasts for the next 30-50 years.

I would say that the first issues to work out just how long it's going to take the baby boomer generation to die (that's my generation!), because it's that generation that is 'top heavy' on the demographics (ie, supported by a much smaller working population).

Second, it's just how much care they will need before they die (of which the three 'biggest causes' for needing care of course obesity related medical illnesses, such as diabetes, and then 'substance abuse' - mostly alcohol and nicotine! - and finally our hideous old friend, dementia).

BUT, against that are two other factors - firstly whether those three above are actually going to shorten 'natural life', or the complete opposite, that medical advances will be such that these three can be cured, so that the baby boomers end up NOT needing care (or very very little) ....ie, that we can all grow old as 'super-agers' etc.

Obviously any rational government (often an oxymoron...)(ALWAYS an oxymoron??) would be to budget for neither premature death nor superaging, but to assuming that the baby boomers will all reach 100 plus, but in incredibly poor health needing huge amounts of care (possibly one carer per caree?? A HORRENDOUS ratio....)
Japan ?

Following their first set of measures , a decade long stagnation in growth leading to a loss of trade , particularly exports , to their immediate Asian neighbours ... South Korea in particular ... their car industry a prime example.

Much the same is anticipated over here ... not social care measures ... the effects of the wrong flavour of Brexit.

Politically , it is splitting one party apart ... the other mired in it's own worries.

So much for the " Political will " towards doing anything positive for the welfare of it's citizens ?
Oh, I thought you meant they had a budgetary programme for funding infirm old age, but it was proving insufficient.

The only thing I remember about Japan is firstly that people DO seem to live to a huge old age (whether ripe or not I don't know), and secondly that the country was 'shipping out old folk' to care homes in warm, cheap sunny places like the Gambia....
179 posts