IPPR Case for Free Personal Care report

May 28, 2019

Following campaigns by Independent Age, Institute for Public Policy Research (IPPR) has released a report with evidence to show the case for free personal care.

The think tank's report states that introducing free social care for everyone over 65 would save the NHS in England £4.5bn a year by enabling more elderly people to receive care in the community.

Under IPPR’s proposal, older people who could afford to would still pay for their own accommodation costs but not for personal care. The reform is similar to the system already in place in Scotland and would more than double the number of people receiving state-funded care, says the think tank.

The case for free personal care report argues that the change would:

  • Create parity between cancer patients and those living with dementia.
  • Increase the number of people with access to state-funded care from 185,000 to 440,000 (if it was delivered and fully taken up today), reducing unmet need and relieving pressure on unpaid carers.
  • Help hospital patients to move back into the community, and deliver a higher quality and better integrated service.

Acknowledging the extra investment needed to provide free social care, the report notes that spending on adult social care for the over 65s would rise from £17bn a year today to £36bn in 2030, before NHS and other savings are factored in. However, £11bn of that increase would arise even within the existing system because of the growing elderly population, and there would be benefits to the wider economy, including jobs for the estimated 70,000 new full-time workers needed to meet demand.

The report argues that free social care for the elderly should be funded from a 2% rise in income tax rates. Recent polling by Independent Age found 74% of adults supported free personal care for everyone who needs it, with 69% willing to pay more tax for this.

As well as providing the case for free personal care, IPPR also calls for simultaneous reforms to the way social care is commissioned and delivered in order to provide a more joined-up system of health and social care provision for older people with complex needs. It suggests a system of integrated health and care commissioners under which GPs, nurses, mental health workers and social care workers would work locally in integrated teams.

The report follows three decades of indecision over social care reform and comes as spending on social care has fallen by more than 10% over the last decade as a result of the squeeze on local authority budgets.

Harry Quilter-Pinner, Senior Research Fellow at IPPR and lead author of the report, said, 'If you develop cancer in England you are cared for by the NHS, free at the point of need for as long as it takes, but if you develop dementia you’re likely to have to pay for all your own social care - running up potentially catastrophic costs in the last years of your life. This makes no sense.

'By investing in personal social care so it is free at the point of need for everyone over 65, we can provide a better and more integrated care system, one that’s fairer to us all.'

Dean Hochlaf, IPPR Researcher and co-author of the report, said, 'Over the next decade the number of older people in the UK is set to grow substantially. This will bring with it more people facing diseases of ageing such as dementia, as well as higher levels of frailty. We need a social care system that is fit for purpose.

'Adding a penny or two to tax is a small price to pay for creating a simpler, joined-up system in which we collectively contribute to the costs that many of us and our relatives will otherwise face.'

Sir David Behan, Chair of Health Education England and former Chief Executive of the Care Quality Commission, said, 'In 1948, politicians were brave in making the NHS free at the point of need and funded out of general taxation. We need our politicians today to be just as courageous and do the same for social care. After all, the hallmark of a civilised society is how well we treat the most vulnerable, including our elderly parents and grandparents. At the moment we are failing them but it doesn't have to be that way.'


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