27 August 2009 Contents 01 Shaping the Future of Care Together: Some initial responses

01 Shaping the Future of Care Together: Some initial responses

1. there is a lack of focus in the Green Paper on young disabled adults;
2. the new National Care Service should be non-discriminatory on age grounds;
3. the discussion around the Green Paper should address the key resource issues raised by In Control's experience of Self-Directed Support
4. (and related to this last point) that discussion must not be confined to the three funding options set out for discussion in the government's Green Paper.

1. They call for clarity on the roles of national and local government. They point out that the government has provided two options in the Green Paper for the National Care Service, (a) part-national/part local and (b) fully national, while they (the King's Fund) argue that previous evidence showed strong support for a national system and an end to the 'post-code lottery'.
2. They stress the way in which the funding options in the Green Paper focus largely on older people, while "the biggest current pressure on councils' social care budgets are from learning and disability services"; and they stress the need for further clarity about the way in which the needs of adults of working age with disabilities will be met.
3. They also ask for greater clarity on the possible consequences of the suggestion that the Attendance Allowance might be integrated into the new system and concerning the Disability Living Allowance, which is not touched upon at all.
4. In general, they argue that a suggestion in the Green Paper that different approaches might be taken for different groups does give rise to issues of age discrimination.
5. In approaching their discussion of the government's funding options they indicate that there are some possible options which the government have not considered, including those which would set a limit on an individual's liability. They instance one such proposal, to raise capital limits for home care fees from the current level of £23,000.
6. Perhaps the most serious criticisms of the King's Fund briefing are those regarding the lack of any adequate costing of any of the three options brought forward in the Green Paper, "making it difficult to assess the merits of what is being proposed". They state that costings contained in the Impact Assessment of the proposals are "partial" and "the Green Paper does not make it clear how much additional money each option would bring into the system in order to help address the estimated £6 billion short fall in funding." "...a full costing of each option will be essential," they argue.

1. Age Concern "strongly supports the need to raise further funds to pay for a better care system".
2. It strongly supports the 'pooling' of risk in paying for care, but warns that costs must be fairly shared across the generations.
3. It is concerned about the abolition of the Attendance Allowance "simply to prop up the system as it is today".
4. The Green Paper floats the idea of older people paying a lump sum of at least £20,000 from retirement as a form of social insurance, something which was rejected by older people in research carried out by Age Concern; while, at the same time, it does not seek views on lifelong contributions;
5. The Green Paper "stops short of suggesting that care home accommodation should be met" [Editor's comment: The Green Paper specifically says: "When we talk about a new care and support system, we do not include paying for the place a person lives in or for their food. People must pay for these whether or not they need care and support services." (Shaping the Future of Care Together (Easy Read version), p. 27)];
6. Age Concern has also called for more emphasis in the debate/consultation on the provision of more preventive care and how the quality of care can be improved.