MPs back change to Government’s Health and Care Bill

November 23, 2021

MPs backed an amendment to the Health and Care Bill last night, to implement the Government's version of the social care cap.

The reforms include a cap – or limit – on the amount people will have to pay towards their personal care. It will be set at £86,000. After this has been reached, the local authority will pay for the care. This does not include living costs such as food, energy bills or accommodation.

The Commons vote saw 272 MPs to 246 in support of a change to the Government’s social care reforms.

Around half of all older adults in care receive some state support for their care costs under the current system, according to Government reports in its Adult social care charging reform: Analysis (published 19th November 2021) and the Government promises that ‘no one will be worse off, and some will be better off, as a result of these reforms.’

When the Prime Minister announced his intention to activate Sir Andrew Dilnot's cap on costs three months ago, Age UK said that this reform was definitely worth having; however, increasingly, Age UK says the jury's out.

Commenting on the Government’s decision, Caroline Abrahams, Charity Director at Age UK, said, ‘The Government's amendment may have been passed by the House of Commons but no doubt the House of Lords will fulfil its constitutional role and give it the intense scrutiny it needs. We hope Peers will vote to overturn it.

‘No one disputes that the amendment significantly waters down the Government's plan for a cap on catastrophic care costs and does so in a way that protects only the better off. This is unfair and means the people who are most in need of protection against the risk of their care bills wiping out all their assets are least likely to receive it. Many of these older people whom the Government is now proposing to let down will have bought their council homes under the 'right to buy', an extraordinary situation for this group of Ministers to have created.’

The announced reform includes the following:

  • From October 2023, both new entrants and existing social care users will be able to progress towards the £86,000 cap on eligible personal care costs.
  • The increase in the Upper Capital Limit of £100,000 will apply universally, irrespective of an individual’s care setting or circumstances.
  • Between the Upper and Lower Capital limits, if individuals are not able to pay for their care from their income, they will be expected to contribute up to £1 in every £250 from their chargeable assets towards the cost of their care.
  • The notional level of ‘daily living costs’ (DLCs), being the amount an individual needs to pay when in residential care that does not contribute to their capped care costs, will be set at £200 per week.
  • For individuals who receive financial support for their care costs from their local authority, it is the amount that the individual contributes towards these costs that will count towards the cap on care costs.

Caroline Abrahams added, ‘The fact that the Government is now intending to effectively gut their proposed cap on catastrophic care costs is therefore just the latest in a series of wholly unsupportive decisions so far as social care is concerned. What are we supposed to think about the Prime Minister's pledge to “fix social care” now?’

Following the Government’s decision on the Social Care Bill, Dr Louise Grant – a former social worker turned social care academic and now Executive Dean of Bedfordshire University’s Health and Social Sciences – says that the focus on funding is not enough and that we need to look at the bigger picture surrounding modern social care.

She said, ‘Any discussion about improving social care is welcomed by professionals and educators. For too long social care has been neglected, as have the needs of the population and the development of the social care workforce. While the current political discussion is focused on funding, it has also highlighted the issues of inequity in service delivery to the most vulnerable, frail and disadvantaged members of our society.

‘Modern social care needs fundamental system change and a focus on workforce development and career progression. If we are to attract people to the profession, it is vital that individuals feel they can grow and develop, ensuring they feel valued and able to provide the best possible service to people who need it.

‘So, while social care funding is currently being prioritised, a more comprehensive discussion is necessary. As Gandhi once said: “The true measure of any society can be found in how it treats its most vulnerable members”.’

A ‘cap’ is a term used across the globe, too. Simon Bottery, Senior Fellow in Adult Social Care at The King’s Fund, reported on the variations of caps in Wales, Germany, Australia and Japan in a blog post in September. In Australia, for example, the cost of residential care for older people is capped annually at around £15,000 and over a lifetime at around £36,000.

In other news, since Government published its policy paper in September, the sector has been subject to the Autumn Budget and Spending Review, which was poised to share further details about how the proposed social care reforms would be funded, particularly from a local authority perspective.  In the latest issue of CMM, we ask: Are the social care reforms enough to sustain the sector and those it supports?


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