Loan money for elderly residential care a "token" part of Dilnot Report

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Under new government plans, the elderly and vulnerable will be eligible for council loans to fund care home residencies, with the cash repayable after death.

Elderly Care Fees

The 'deferred payments' scheme, to be launched from 2015, will permit councils to pay in advance for care if individuals cannot afford it without selling their home. Local authorities will recoup the cash after the individual's death and the house is sold.

At present 40,000 people annually sell their property to meet care costs. The Health Secretary, Andrew Lansley said: "It is hard enough for people to come to terms with needing to pay for extra help when their circumstances change – whether their health has suddenly deteriorated or age has started to take its toll. The last thing people want to think is having to immediately sell their home to pay for residential care."

Some 8,500 people in England have borrowed about £200m under an introductory version of the deferred payments scheme, which is among measures proposed by the 2011 Dilnot Commission.

However, the scheme is the only part of the Dilnot report that will be enacted. Ministers have refused to commit to Dilnot's key proposal of capping the lifetime cost of care to £35,000, insisting that cheaper options must be explored first due to the current climate.

After 1 year of consultation, Mr Lansley said Dilnot provided the "right basis" for change. However, he added that he could not yet fully commit to every provision and that a final decision would be made by the next spending review – which could be 2 years away.

In addition to capping, the government also wants time to consider extending support for the elderly with assets of £100,000 from the current limit of £23,250, saying the 2 measures combined would cost nearly £1.7bn.

Although around 25% of people will pay nothing for social care, 50% can expect care costs of up to £20,000, while 1 in 10 can expect their costs to exceed £100,000.

According to a recent Age UK poll, 89% of English adults believe that older and disabled people should not have to bear all the costs for support even if they have "a small amount" of savings.

Notwithstanding that much of Dilnot will be deferred, some experts have pointed out that the proposals which are enacted will only affect those in need of social care, not nursing care.

"Individuals whose care needs are health-related will still be entitled to NHS continuing healthcare funding," said Lisa Hashmi, adding that the costs of their care will remain the responsibility of the NHS – theoretically free at the point of delivery.

"We see daily the financial and emotional impact wrought by wrongful denials of continuing healthcare funding, both on the individual concerned and their loved ones," noted Lisa. "It is vital that those looking into the issue of care understand the differences between health and social care, and the potential impact of any proposed reforms to the way that care is organised and delivered."

Lisa's colleague at Simpson Millar agreed, adding that most carers and families are not aware of the NHS funding, while many professionals are failing to recommend or advise families that the funding exists.

"Many social workers think no further than local authority contribution which means genuine patients are denied the opportunity to receive funding, which often means they have to sell their home to meet their care costs. With people living longer, this is a crisis that token reforms will not resolve."

Liz Kendall, Labour's shadow care minister, said the government's decision to delay long-term care funding will disappoint thousands of older and disabled people and their families.

"It will be a huge blow to local councils, who are desperate for a new settlement on funding social care," said Ms Kendall. "And it will be disastrous for the NHS, which will face intolerable pressure as crumbling care services are eroded further still and more older people end up in hospital when they don't need to."


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