By Professor Catherine Needham, Professor of Public Policy and Public Management
Health Services Management Centre, University of Birmingham
Yesterday in the Autumn Statement, the Chancellor Jeremy Hunt confirmed what had already been hinted: the cap on social care spending by private individuals would be delayed past its planned implementation date of October 2023. Instead, there will be a two-year delay. In the meantime, individuals remain exposed to the potentially very high costs of social care (if they need intensive levels of care for a long time) in a way that we would never tolerate people being exposed to health costs.
The delay is an almost exact repeat of what happened under the Cameron government: a cap on social care spending was passed into law in the Care Act 2014, then was delayed for a couple of years because of concerns about cost and implementation, then quietly abandoned. When the care cap came back as a policy idea under Boris Johnson, I was hopeful that lessons had been learned from its previous outing. It’s very clear now that those lessons were not learned, and the cycle of legislation then delay (and possible abandonment) is underway again.
The planned increase in the means test threshold for social care is also being delayed. This is bad news for older people who have assets above the means test threshold and have to pay for social care out of their own pocket. It’s an abandonment of the promise in the last Conservative Party manifesto that people will not have to sell their homes to pay for care.
This isn’t a policy that only affects rich older people. The current means test threshold means that people with assets above £23,250 get no state help to pay for care, a figure that hasn’t been updated since 2011. Inflationary changes mean that more and more people are excluded from state support, increasing the ‘self-funding’ population. Almost half of English people who use social care pay for themselves, usually left to their own devices to make major decisions around what support is appropriate for them.
In an article published earlier this year, Patrick Hall and I looked at ‘drift’ in social care reform, and why policies don’t get updated even when everyone agrees that change is needed. We compared the four nations in the UK and found that England was particularly susceptible to policy drift. The prevalence of veto players (especially the Treasury), the bitter partisan polarisation on reform proposals, the distraction of Brexit and the ongoing effects of austerity have meant that care funding reform has been repeatedly pushed down the road. In contrast, both Wales and Scotland have made changes to their social care funding which reduce self-funding.
We ended that drift article noting that the care cap had been passed into law in England for a second time (in the Health and Care Act 2022) and wondering if this marked the end of drift. Instead of that, financial pressures from central government and implementation concerns within local government have yet again kicked social care funding reform deep into the long grass.
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The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of the University of Birmingham.