On Tuesday I was invited onto the Today programme to talk about the Dilnot Report. I explained to them it was not an issue I had been campaigning about, not even an issue where I had come to a strong or different conclusion to current policy. They were still keen to question me about the subject.
The news peg was a letter in the Daily Telegraph from numerous leading charities and other interested parties. They said there is a crisis in care for the elderly. They urged the main political parties to continue talks to reach a cross party consensus on reform of the system. It is difficult to disagree with that. Cross party agreement to change could guarantee less future change or disruption, if the parties hit on a good answer.
I suggested that we should start from the question of how do elderly people get access to the care and support they need? If there is a crisis, it is because too many elderly people are not being looked after well enough or do not have a good choice of future care home provision. I have been worried by some reports of the poor treatment some elderly people have experienced in care homes. I am concerned that some elderly people living in their own homes do not get the help they need with shopping, cooking and other basic daily chores, making their lives uncomfortable and even dangerous. Reading the Dilnot releases again, they seemed more preoccupied with the issue of who should pay for the care and accommodation, and spent considerable time discussing how to preserve more of the childrens’ inheritance from parents who need expensive care and accommodation in their old age.
The Dilnot proposals suggest that allocating £1.7 billion more a year to this area would ease the problems. This money seems to go primarily to lessen the amount that individuals would pay from their own resources when they needed to live in a nursing home. The Dilnot suggestions include raising the means test threshold from £23,000 of assets to £100,000 of assets before you need to make full payment, and capping the total that anyone had to pay for nursing or care home fees to £35,000 however long they lived in such a home.
The current cross party consensus is based on three main principles. The first is that medical care should always be free, under the NHS. Elderly people tend to need much more medical attention than younger people, and should not face financial penalties for this need. The second is that if an individual has little or no money and property of their own their nursing or residential home would be provided free to them, so they could have a dignified and warm old age at no cost to themselves. The third is that if an individual who has financial and property assets needs to live permanently in a care home, they should pay for their food and accommodation all the time they have the means to do so.
Some object strongly to the fact that the old family home has to be sold to pay for the nursing home, if just one parent is still alive, needs to move into a nursing home, and has no other money. There is no question of using the asset of the family home if the other parent still wishes to live there. I would be interested in your thoughts on whether you think the current system is based on the wrong principles, and if so what changes you would like to see in the provision of care and payment for it.
January 5, 2012
The NHS should certainly not be free at the point of use, for those who can afford it, any more than having a hair cut should be and tax should be reduced to leave people with the money to pay. People should also pay for and provide their own long term care where ever they can.
Perhaps some system needs to be in place to ensure that those who have made not provision or in rented accommodation are required to make some provision – so that the state does not have to pick it up for them in the end anyway.
January 5, 2012
Lifelogic, I normally agree with your views. On this point I do not. It cannot be right that people in social housing can live in the same or better house than their neighbour who works all their life to scrimp and save to buy their own house while their neighbour idly stays at home. At the end of their working life the workers have to sell their house to pay for their care and to be in the same care home as their neighbour who pays nothing and has done so all their life. What incentive is there to work, save worry about how to make ends meet when the idle get it all for free. Oh, and johnny Foreigner can take up the idle mantle any time he/she wants and to ask for a car home as well without paying into the UK tax pot. That is why IDS is challenging the so called welfare tourists that the EU think ought to have a right to migrate to any country in the ERu even if they are out of work.
Vote Labour or Lib Dems as they create systems where it does NOT pay to work, save or buy a house. Only trouble is if we all did it, who would pay taxes to make it happen??
January 5, 2012
I sort of agree with you. I do not anyway think any social housing should be provided at below market rent anyway. People who need help with rent get it anyway.
Also as I say above perhaps people with no house or capital to use to pay for their care fees should perhaps have to make some provision in some other way by insurance or paying into a government scheme.
Those that do have houses should perhaps be able to limit liabilities perhaps £25,000 or something similar by taking insurance or a government scheme. After all most still die at home needing no such long term care. Last time I looked only about 20% needed long term care homes. Clearly for a small minority it can be a very big bill indeed but not for most.
Also taxes should be reduced to reflect the fact that people would then be making their own provision.
January 5, 2012
There is of course the matters of transition and graduation to be addressed. It would certainly not be fair to make someone nearing retirement to pay full whack for NHS medical care, when they have paid NI contributions all of their working lives.
While the UK continues to exist it is also extremely unfair for Scotland to have free prescriptions and care of the elderly at UK taxpayers expense.
January 5, 2012
Indeed
January 6, 2012
It has been announced that social housing rent is capped at £400 per week. That is £1600 per month, how many workers could afford this???? Then these people are given free elderly care and live in the same homes as those who worked all their lives and had to sell their homes.
The Lib Dems are an absolute joke on the taxpayer. On top of this they insisted on giving welfare lifers a 5.2% pay rise!!
Wipe socialist LibDems off the map we simply cannot afford them.
January 5, 2012
Disaffected
Agree totally.
January 5, 2012
We are already there. That is what the problem is. People voted Labour or Lib Dems as they create systems where it does NOT pay to work, save or buy a house. They have voted, and their parties delivered. Now we cannot pay taxes to make it happen. So who will clean up the mess?? Well, the ‘nasty’ Tories, of course, who will take away all the freebies given over the last 13 years.
A good example of Democracy not working.
January 5, 2012
its worse than that
guy with 2 kids gets kicked out of the army for being useless finds himself in a housing association house which is nicer in every way than the army houses the soldiers still in the army have to live in with their kids
this country is crazy in so many ways
January 5, 2012
As long as minimum wage remain low then there will be little difference between benefits and working for some people. The low number of jobs also means that 2.64 million people will remain unemployed no matter what they do.
People shouldn’t penalised for no working when there weren’t enough jobs available for everyone.
January 5, 2012
Well people should perhaps not be penalised but they did vote for Labour three times (and nearly four) and it is their policies of over regulate, an ever bigger state, tax borrow and waste, green energy and the EU free movement of workers that causes the lack of well paid jobs.
There is little prospect of more jobs, and certainly not many well paid ones, until Cameron starts to turn this around – if indeed he ever does start.
There is, however, every prospect that benefits will have to be further reduced as the government is forced further by markets to balance tax receipts and its expenditure.
January 5, 2012
Look further down the blog and you will see examples of Johnny Foreigner bringing their relatives to this country for free health and elderly care. Greene has still has not made any substantive changes to the immigration travesties that cost all of us a huge amount of tax. How long does it take to say stop until we have a proper system in place???
As for jobs, it would help if immigration was drastically cut.
January 5, 2012
to some degree i sympathise with this view, especially in some parts of the country where nobody but nobody would be able to get a job
on the other hand we still have lots of folk coming in on work visas and many get indefinite leave to remain and british passports after a few years, this removes any incentive to hire or train brits, and needs a much more radical look at
the incentives in the system need to be tweaked to encoruage people to do the right thing, at the moment many of the incentives encorage folk to do the wrong thing
January 5, 2012
Many believe they should be. If they are starved enough they will work.
January 5, 2012
It is interesting listening to the BBC coverage of the Diane Abbot after her (arguably-ed) racist (and also untrue) “tweet” – it is mainly softly on her side I note. Much talk of the limits on the number of “twitter” characters permitted, as if this were a mitigating factor.
Perhaps a far more clear and damaging racism is that, constantly shown by the BBC in its selective reporting. When for example one particularly evil and horrific murder, receives so much more coverage from the BBC and other media (and vastly more police resources too) than other equally or even worse murders simply because of the race and politics involved.
Is this not actually totally counter productive to true harmonious race relations?
I cannot help thinking that to legally define some murders as “hate crimes” is equally counter productive and obnoxious as a concept.
January 5, 2012
The story was mainly the racism, length of investigation and incompetence of the investigation. This is why the story was so big. Do not attempt to dilute it. The BBC was just one of the many news organisations reporting this story. You would not know as you do not watch other news channels. The newspapers where also full of this for a long time.
January 5, 2012
The story was so big because it suited the government, the BBC and the police to make it so – above very many other often even worse crimes. Just as that other, absurdly over done, story by the BBC – the voice mail tapping and the great war against Rupert Murdoch suits them.
But they are not just another newspaper that we can take or leave. We are all forced to fund their socialist, pro EU indoctrination & job & democracy destroying agenda. It sets the whole tone for such UK democracy as still remains.
January 6, 2012
This was reported extensively on all channels not just the BBC. Your point would be justified in the sense of the massive Madeline McCann story. Would the same coverage be given to a poor British Indian child. I think not, but this is not what you are saying is it? Murdoch is playing with democracy and is fair game for anyone don’t cry for him.
January 8, 2012
I am more concerned by the BBC playing with (what is left of) UK democracy than Murdoch. I am not after all forced to fund or listen to the Times or Sky. The BBC does far more harm and is funded by taxes.
So you money is taken and used to indoctrinate you with left wing, big state, pro EU, enforced “equality” BBC think.
January 5, 2012
What do you propose if the NHS is not free at the point of use. Who will pay and what will they pay for? Simple fundamental questions that you for obvious reasons cannot or refuse to answer. Who will pay and what will they pay for? If you think people should be refused treatment for being unable or unwilling to pay then say this.
January 5, 2012
Let’s start by charging £15 for a GP appointment for all who can afford it.
January 6, 2012
People would just not go leading to all sorts of problems whether they could afford it or not.
January 6, 2012
Most sensible counties do charge – there would need to be some provision for those few truly unable to pay.
January 6, 2012
1 Replace the NHS with a state backed insurance scheme where everyone is covered, and people as now pay in according to ability and get out according to need. But get the state out of the business of running healthcare providers. Open up healthcare provision to the free market with a few incentives to provide care in particularly remotes places and so on. State insurance company pays out to patients when they need it and the PATIENTS decide where to take the cheque, not the GP and not the PCT. Radically changes the incentives in the system and providers will have to do a lot better at meeting the needs of the patinets. Allow patients to visit any GP anytime and pay GP’s per consultation not per patient on their books (many of which can never get to see their GP in practise).
2. Nominal fee for those that can afford it to visit GP.
3. Stop providing healthcare free to folk without indefinite leave to remain in the UK from countries which do not provide reciprocal care for Brits in their country.
Easy, the vested interests in the NHS wont like it but tough they have been providing rubbish service for far too long!
January 7, 2012
That will work as well as the care home fiasco and the dental services as they stand at the moment. Any profits from healthcare need to spent on the sick of this country and not on more wealth for the rich to be sent abroad.
January 5, 2012
The problem has arisen because the state decided to take on the role that was previously that of the family. It was not the intention the intention was to help those who had no other means of support as is right in a caring society. So we now have a situation whereby the incentive for relatives to look after one another in sickness, old age and adversity has been removed. We further have a situation where the state revenues are insufficient to resource all the services and benefits that the state currently provides. There is only one practical solution and that is for the state to revert to the original intention of the welfare system and support only those who have absolutely no other means. If families prefer to abdicate their responsibilities to their relatives then they are going to have to pay for that privilege even to loss of inheritance.
January 5, 2012
This is the brutal truth we have to face. What might have been affordable and possible under very different demographic conditions decades ago and in a time when most people rented housing cannot continue at the present. None of it is “free” it has to be paid by somebody. This one is yet another issue that has been coming for a long time and government’s have avoided.
January 5, 2012
Antisthenes, January 5, 2012 at 7:48 am
“There is only one practical solution and that is for the state to revert to the original intention of the welfare system and support only those who have absolutely no other means.”
It can easily be arranged to have “absolutely no other means”.
As my Grandparent’s neighbours approached retirement, they went on several ’round the world trips until they had spent all their money. They actually said, after returning from the last trip, “Well, the State can look after us now”.
This happened in 1966, so we have been a long time getting to where we are now.
What is to be done?
January 7, 2012
In other words a return to the workhouse for those with not enough money as an incentive. Not acceptable in modern Britain and guess what? The population will not accept this in such a wealthy country such as this where money that does not exist can be found to bail out banks and fund foreign wars. The rich elite should not be allowed to get away with this backed by middle class nitwits who think they are outside society. Many are a pay packet away from broke.
January 5, 2012
John,i would want to deal with the sick pay of care staff and agency costs before asking elderly for money.I would also want to change the spend every penny culture.This is often done to secure more funds for the following year.Empty beds in care homes cause the same financial problems as empty hotel rooms
January 5, 2012
Considering most of the elderly have worked all of their lives and paid into the system, they certainly ALL deserve to be looked after. Many of us paid into private pensions to ensure our future security, pensions that are now worthless. Will we be compensated or treated as though we are asking for something we haven’t contributed to and left in substandard nursing homes?
We seem to have unlimited funds to give away to third world countries and none to look after our own people. The money we give away should be ample to care for our elderly. A governments first duty is to protect ITS OWN PEOPLE not the world and his cousin!
January 5, 2012
No-one has paid into a “system”. National Insurance is a fake – it is simply another form of income tax with no savings to back it other than current exchequer.
The idea that we all “deserve” to be provided for in old age is an outrage. It’s a classic example of people relying on the nanny state whilst having no idea of where the money comes from to pay for it all.
We work and we save so that we can care for ourselves, our families and, out of charitable compassion, for those who are less well off than we are. One of the things people living in the west need to get their heads around is that we are not owed a living.
January 5, 2012
No its not a fake. The money is taken and the state promises cradle to grave in return.
However politicians want to sell you the insurance on one hand, but then say its a tax when you want the payout.
The problem is that the state has taken the money for the service, spent it, and now can’t provide the service. Pensions, old age care are all examples.
What should happen is that people should not have been taxed in the first place, but they should have been made to save when they had the earnings. [You being forced to save for yourself doesn’t trump you forcing me to pay because you didn’t save. I win]
The problem is that the state won’t reliquish the tax (because of its debts) freeing people to save for their retirement and old age.
On the ‘not being owed a living’ the answer is yes.
Take Labour. They are still campaigning against changes to a system that gave benefits of 170K a year tax free to claimants in Knightsbridge.
January 5, 2012
It is fake – in that it is just a tax, but presented so that politicians can say it is not a tax. When you pay 12% on your salary and your company pays in 13% on your salary, that is 25% tax on your salary, however it is sold to you. The money is NOT ring-fenced, it is lumped with the rest of your tax money and dished out as the government chooses. (not sure of the exact %)
January 5, 2012
@Robert “No-one has paid into a “system”. National Insurance is a fake” – I’m certainly not disputing that fact but NI was “billed” as a National Insurance against sickness, unemployment or disability.
I paid (not voluntarily I might add), a considerable amount into the fund in good faith over a period of more than 30 years.
Had I had a choice of opting out, I would have preferred to pay for a private health scheme, just as I paid into my now WORTHLESS PRIVATE PENSION!
Alot of good all these government cons have done us!
January 5, 2012
John,
Without getting into an EU rant, I wonder how many people are aware that with the influx of EU immigrants how many elderly are cared for by the state in care homes at public expense.
My mother at 97 is in a care home and she is one of only 3 paying (with our assistance) for her care. There are 2 Eastern Europeans in the home who’s siblings have been over here for about 3 years being totally funded by the state.
I’m sure this is repeated all over the country and I would like to know how this helps our economy?
January 5, 2012
I have to agree – with the sentiment that the public sector simply do not see any thriftyness as necessary with tax. Everything is gold plated. Letting in immigrants is not a problem as long as they are NET tax payers over their lifetimes. There is so much sentimental SLOP about giving people from the other side of the world rights and not enough about old people having rights who have paid taxes all their lives.
The attitude and sentiment and drive should be to look after those who pay tax and ensure that anybody coming into this country will benefit this country and those living here.
HOW ELSE ARE THINGS GOING TO IMPROVE ?
January 5, 2012
On net taxpayers – correct.
Government spend – 11K per person on average.
You need to earn 40K a year (per migrant so you have to multiply it by the number of dependants)
Simple check should be on a tax return, plus a bond for the first year.
Instead we get Stalinist central planning and points systems.
If your tax drops below the threshold, make it up or leave.
January 5, 2012
Agreed. I think the human brain just doesnt get SUSTAINABLE.
Its true in the EZ – its true on the high street and its true with taxes.
January 5, 2012
“Without getting into an EU rant, I wonder how many people are aware that with the influx of EU immigrants how many elderly are cared for by the state in care homes at public expense”
All this has not been taken into consideration. How many extra people have we been providing for from our years of taxation? During Labours 13 years of power and uncontrolled immigration, how many of those people went into full-time employment and paid taxes and how many have we “long terms payers” been supporting?
Not forgetting that Gordon Brown plundered our pensions.. and where did that go on? Social benefits for millions of extra people.
January 5, 2012
To be fair, however, most of the staff in care homes appear at casual glance to be immigrants so, in this sector, their net contribution is almost certainly positive.
January 5, 2012
Those who make provision for themselves in this country (we used to call them prudent) are taxed to the hilt and expected to subsidise not just those who are unable to provide for themselves but those who don’t choose to, either through idleness or by being spendthrifts. Is it not the case that those who do pay for their own care are made to pay more than those whose care is paid for by the taxpayers via the state? The reward for being “prudent” is that not only are you expected to pay for your own care directly but also charged more and taxed to pay for those who weren’t “prudent”. Governments are continually giving incentives to the indolent and extravagent. It is time that they adopted a different approach.
Reply: the paradox of a welfare state is just that – if you are successful and prudent you have to pay for yourself and contirbute to pay for others who were not prudent. This example is but one of many. The idea behind welfare reform from this government is to try to strengthen the incentives to be prudent and to provide for yourself and your family. It is not easy as most accept the premise that everyone should be helped when they need it.
January 5, 2012
You could at least allow folk who have to contribute out of their own funds some tax perks.
In some other countries that have funds available similar to our own personal pension funds, into which you can contribute escaping income tax (although here you mostly get taxed when it comes out).
Such funds can be used for medical care, old age care, as well as traditional pension pot as here.
In addition families can have many members pay into the same family pot which for large families can be a good way of pooling the risks without an insurance company taking a profit out of the funds. Can replace medical insurance as well as old age care funding if the family is big enough.
There is some good in these approaches, but importantly we need to find ways to incentivise people to save, at the moment there is little or no incentive to save. Lots of people play the system by making sure the funds are in someone else’s name when the time comes for means testing, it is only the decent honest people who end up being stung. And even honest people why should they save if it’s only going to be taken away from them anyways? They may as well go on some extra holidays or whatever and burn the money in advance.
The other reality is that if people really controlled the purse strings mostly the sham of care provided by the NHS and local authorities would be out of business, no way would people pay out of money they controlled themselves for this rubbish service. Mostly people controlling their own budgets would be best for everyone, although the vested interested in the healthcare field wouldn’t like their cosy easy life being shuck up.
We could start with the easy stuff, reward decent honest hardworking contributors to the system by bringing back a link between how much you pay in over your life into how much you can have out. Also clear unfairness like folk who are immigrants to this country at the age of 60 odd either come in with the funds to cover their own old age or they shouldn’t be allowed in!
Needs a fundamental rethink of the whole system.
January 5, 2012
This is correct – Councils are using self funded residents in elderly care to subsidise state aided ones by paying less than the full costs of care. This practice should end. All residents should pay exactly the same however funded and a breakdown of costs presented regularly.
Similarly home care costs should be more transparent with a breakdown of costs presented regularly to their “clients” as you would expect for any other service you paid for.
It is probably not right, or affordable, for the state to pay the full costs of care for those sitting on very large assets, whether it be a house or anything else.
January 5, 2012
What happens if people can’t pay because they worked all their life in a low paying job and have no savings?
January 5, 2012
What happens when people have worked all their life in a low paid job and STILL saved for the future and paid off their house, didn’t take a holiday every year, bought second-hand cars, etc? Why should we treat the hard-working, thrifty people worse than the wasteful?
January 5, 2012
They do not deserve treatment as they did not pay. Once they come out with this their argument is finished, so they do not.
January 5, 2012
1. ‘Free’ medical care – OK
2. ‘No money’ – Free nursing or residential care – ok
3. With money and assets – pay for food and accommodation. – Not so fast.
Firstly, people have paid in. The prudent in lots of cases have paid in tens of thousands into the system. Why shouldn’t they get the insurance cover that they have paid for, when they need it?
If you take the money for insurance, and they say, sorry we know the insured event has happened, but you’ve been prudent, we’re not going to pay out, then you as an insurance company would be sued.
The reason you as a government won’t/can’t provide it was and is fraud. You’re committing fraud. Same as with the pensions. You’ve taken the savings of people for their old age, and their insurance payments for their old age, and spent it. Now with no money, you’re going to screw over the customer.
What needs to be done?
How about jailing those responsible for this fraud, confiscating their assets and using those as a basis for paying out to those in need?
Long term, people need compusorary savings, and government provision of pensions and old age care abandoned. With the savings, people can pay for it themselves.
Reply: People would have “to pay more in” as you put it to get the extended cover you want. Having your food and accommodation paid for in old age was not part of the deal offered. The issue is should the deal be improved, and if so, how do you pay for it?
January 5, 2012
It seems unjust that the taxpayer should fund care for the elderly in order to protect children’s’ inheritance.
If only.
January 5, 2012
J.R. , Nick ,
You pay for by reducing the cost of living , specifically accomodation , so people have a surplus to save and then provide them with access to schemes which makes it worthwhile .
I suggest the principle that natural resources are collectively owned by the whole community (as mineral resources are by the crown) be re-established and extended to include the limited natural resource of land .
Put simply , the dividends of the land component of a property or premises should accrue to the country as a whole and the improvements , such as the house/premises to the owner(s) .
Thus two lots in a city , one vacant , one with a tower block on it , would be required to pay the same annual rent to the country in proportion to the value of the empty lot .
This discourages hoarding of land and resources and should increase supply of premises and accomodation .
The current system merely transfers money from the have nots to the haves , the land owners and the banks which collect interest on mortgage loans on puffed up property prices .
It leaves people destitute in old age so that the costs of looking after them have to be socialised – effectively a subsidy from the taxpayer to the haves which have taken all the have-nots money .
January 5, 2012
John, You answer your own question by previous blogs, namely the government stop spending and wasting money.
January 5, 2012
I would love my in-laws to be looked after by the state so that my wife and I can inherit their money (assuming that’s what they have in mind). However, I know that their care would not be paid for by “the state”, it would be paid for by tax payers, many of whom earn less than I do.
Rightly or wrongly, the welfare state that today’s elderly people “paid in to” was not a savings or an insurance scheme. There is no money sitting in an account waiting to pay for this care. We have to find the money now and it seems only reasonable that a contribution comes from what people would otherwise have given to their children.
January 5, 2012
Rightly or wrongly, the welfare state that today’s elderly people “paid in to” was not a savings or an insurance scheme.
=============
So that’s fraud. Time to jail those responsible.
Until that happens, people will become creative and opt out. For example, equity release to a trust for the children.
It’s a deal. The state is reneging on its part of the deal. The reason its reneging is that it has been committing fraud and running Ponzis.
If John does read the comments, I’m still waiting for the total figures for state debts, pensions included. ie. All the off balance sheet items.
My estimate is 7,000 bn rising with inflation against tax revenues of 550 bn.
It’s not affordable.
It’s going all Greek.
January 5, 2012
1) The NHS should continue to deliver free health care. There is a debate to be had, however, about precisely what it is that the NHS should fund.
2) Everyone should expect to provide for themselves. No one should expect the state, i.e. their fellow taxpayers, to support them unless it is absolutely necessary. There is no divine right to have an inheritance. If the home has to be sold to pay for the care, then so be it. The difficult issue is where caring for one spouse at home ceases to be possible, but the other spouse wishes to remain at home. In such cases the value of the home should be left out of account and the spouse requiring care should be cared for at home if at all possible.
3) The more a state does the more people expect it to do and the less they are prepared to do for themselves. The theory of state provision has recently been tested to destruction. We have reached the obscene position where it is possible to make a perfectly rational choice to be dependent on the state. Dependency on the state should be a matter of last resort and this can only be achieved if the state provides only the most basic of safety nets.
4) Sadly the need for increased state provision is in part caused by the breakdown of family life; fewer people now have a family to care for them in their old age. This is a consquence of state sponsored destruction of family values – another theory which has been tested to destruction. This is another clock that needs to be turned back. God knows how that can be done.
5) What is required is brave leadership: someone who can articulate clearly why it is that the totems of the left have destroyed our society. We have to recognise that we live in a competitive world and cannot feather bed ourselves; after all the money to do that has run out.
Jonathan Mitchell
January 5, 2012
John
What are the rules regarding foreigners bringing their elderly parents into the country then putting them into care. Is this another area where the government has no policy and doesn’t keep statistics as it is too sensitive?
My co worker in Qatar flew his mother over every year from Karachi and claimed medical care at Sheffield Northern hospital as her son worked there.
January 5, 2012
Same old story.
I am a laissez faire liberal when it comes to other people’s needs. I think all old people ought to be told to get on with it etc etc. I do not see why whingers etc etc…….
I am, however, strongly Socialist when it comes to my own needs. Why should I lose out when my family grows old and needs a care home? I pay my taxes. Why shouldn’t the State (that bottomless pit) etc etc.
Allow me (aged 72 with a mother of 100) to remind everyone out there that every time money is taken from the bottomless pit, we take just one tiny step nearer to Weimar, to Zimabwe, and, who knows, to a new Adolf Hitler. We are BROKE.
Hey – what’s an odd billion here and there anyway!
January 6, 2012
That’s it Mike, but the crunch factor here is the British obsession with ‘property’ – as soon as the possibility of inheriting a nice/valuable property comes into play the madness does with it.
January 5, 2012
OK I haven’t read the report but I suspect there are (at least) 4 or 5 issues:
(i) Delineating the near term and the future
(ii) The treatment of homes as a different class of assets to others (e.g. no capital gains if you live in it, artificially low interest rates to protect, limiting supply when there is so much land)
(iii) Motivation to be self-/family-reliant (hey why make provision when there is means testing until the end, hey what can I gift / sell undermarket price now etc?)
(iv) Fear of the “deserving poor” debate – did someone try to make self-provision, was someone lucky in that they bought property at the right time, what was a person’s endowments?
(v) Endowments and intergenerational social mobility.
But for the future I do agree with JR’s starting point, “I suggested that we should start from the question of how do elderly people get access to the care and support they need?” I wonder how we can get competition to act to generate the approaches that efficiently provide the care and support. There are, of course, other countries that are developing technological approaches such as robotic helpers, there are already many products that help to extend independence … so I wonder how such areas of innovation can be encouraged? Could something like the Conservative school voucher system under Michael Howard be useful?
January 5, 2012
re “The treatment of homes as a different class of assets to others (e.g. no capital gains if you live in it, artificially low interest rates to protect, limiting supply when there is so much land)” and not expected to access the capital when you are out of work, an expensive house does nothing to preclude you from getting means tested benefits in the same way as a little cash in the bank will
January 5, 2012
I think I count as “elderly”, being in my late 70s.
We looked after my late father in our home until the last two days of his life. The idea of putting him into a care home did not come into our reckoning. Whether our own children will think the same way when either my wife or myself is substantially incapacitated is a moot point. Personally I would prefer to live in my own home and have someone visit – paid by me so long as I could afford it.
The problem starts with the consequences of hostile government policy towards savers and savings. The Brown tax on pension funds is an egregious example, which has caused the closure of most final salary pension schemes and contributed hugely (£100 billion and counting) to the current deficits on surviving schemes. The current low returns on savings and the high rate of capital gains tax, 28% and unindexed for inflation, are further hammer blows to those seeking to provide for themselves by their own savings. I currently enjoy the benefits of a company pension – but for how much longer will the company continue to fund the pension fund`s deficit and pay my pension? Will my personal savings suffice if that ends? I have held some of my savings for 15 to 20 years and some have done well – until I calculate the effect of inflation on my notional gain and the impact of 28% CGT. When these are taken into account, I wonder why I bothered to take the risk in the first place.
So my advice is to pay more attention to the shocking disparity of treatment between those who have saved for retirement (28% CGT rate) and those who can incorporate their income stream and benefit from a wholly different and more beneficial rate (10% CGT rate). In these circumstances, what is the point of saving? Unless attention is paid to the disincentives which apply to savers and savings, the problem you describe will only get worse and worse.
January 6, 2012
Or allow people to roll over their ISA threshold to an extent?
January 5, 2012
Sod the elderly. I’m 67. When I’m so far gone that I need sheltered accommodation, I intend committing suicide. I’ve had a good life and I don’t want to be a burden on the taxpayer or my family.
January 5, 2012
Ralph
You may wish now when you are fit and well, to committ suicide when you eventually find you are not fit and well, but you may be struck by an event (serious Stroke for example) which leaves you totally incapable of doing anything for yourself.
Yours sounds a simple solution, which many speak about when they are fit and well (perhaps not seriously) but in practice few ever choose to do the deed in the end.
Life is precious, and most, especially those who have a family, realise that when times get more difficult, you look forward to the better times, no matter that they are perhaps fewer, and further apart.
January 5, 2012
“Life is precious”. Ah, but what is life? I suggest that a human being in their prime is very much “alive”. Whereas someone whose mental abilities have gone does not possess nearly so much life.
A snail is a form of life. But a snail does not possess as much life as Einstein when he was in his prime. So if we sacrifice the time and energies of people in their prime looking after those who have lost their mental faculties, there is a net loss of “life”.
The Oxford Union should debate that one.
January 5, 2012
The elderly care conundrum is I am afraid yet another example of where our Welfare state has gone wrong.
As with so many aspects of the system, it simply does not pay to try to be self sufficient and prudent, because then you get little help.
Spend all of your money on what you like, plead poverty, and you are entitled to get all the help you can get, paid for by those who work and pay taxes.
The answer is simple, the government when people start work, offers them two alternative tax/insurance payment contracts, the rights of which it guarantees to fulfill for a lifetime.
You pay a lower rate of tax and insurance, and you have to provide health cover and old age care for yourself and family (children up to age 18), or you pay a higher rate of contribution and get a known amount of State cover.
In other words, the State has/runs its own insurance policy for which it takes payment in the form of another level of tax.
Benefits are gained on a percentage number of years contributions, during a lifetime, say 50 years contributions for full care and medical entitlement, 25 years for half entitlement. For those who fall ill during work, a simple full payment record to date from the age of 18 would give full entitlement.
Clearly the complication is out of work periods, but then your card (as such) could be stamped, as it is now.
My mother was in a nursing home for 4 years (aged 90 at the time of entry) and was fully funded by the NHS under the continuing care proceedure (about 1 person in 1000 qualifies) due to her massive health problems/complications caused by a series of strokes, (which I believe was bought on by serious misdiagnosis/failure by a locum doctor, I still have all of the information on file)
To get that level of care for her, I had to contest 4 medical assesments and be an absolute pain in the arse to all those in the system when fighting for her cause.
The fact that I had Power of Attorny over her affairs helped in that regard, as my views and arguments were taken seriously.
After spending 10 months in a hospital bed, and surviving (just) against all predictions, she was eventually tranfered to a nursing home of our choice (not the most expensive) a 10 miniute walk from our home, so that we could visit her most days.
Whilst in that nursing home (which offered her excellent care) it was clear that there were a number of different rates which applied to the cost of care, usually three bands of cost depending on the level of care required, from minimal, to medium, to high, but in addition it was clear that there were different levels of cost within those fixed bands.
Private residents paid substantially more per week/month than either local Authority or NHS funded residents, so that the Local Authority and NHS residents stay could be subsidised, because in effect they were underpaying the going rate.
Now I have no problem with the local Authority negotiating the best deal possible, but it seems somewhat wrong that those private residents and/or their families should subsidise others, right up to the date of their demise.
The one thing we seem to have lost in this Country, but some of our immigrant families still have, is the willingness of the family to want to look after their own, for as long as possible, I appreciate that is not always possible given family commitments and distance between family members.
My suggestion above about two rates of tax I know is not the complete answer, clearly has some faults, but is surely better than what we have now, were the prudent seem to pay for everyone, includng themselves.
January 5, 2012
medical care on the NHS cetainly is not free when you take into account prescription charges, car park extortion, the fact you often have to go private to get any care and so on
but more importantly very often the NHS fails to deliver the investigation or treatment folk need, it maybe free but you are not actually getting the care that the rest of the developed world regards as basic
as for non health care for elderly you are correct its more important to make sure decent care is provided than worry about who pays for it, however if we are all to loose our life savings in the last few months of life thats pretty bad by anyones standards in the context of the amount some of us pay into the states coffers for care which they mostly fail to deliver
the today programme and its practises is stale and blatantly biased and follows every trendy politically correct nonsense in fashion, i’d like to hear some programmes from the sixties i am sure they must have been telling us all how great council tower blocks were to solve the housing situation
January 5, 2012
Why not encourage more people to accommodate their elderly parents in their own homes? Some could use the proceeds of their parents’ houses to buy bigger ones for this purpose. In other cultures it’s taken for granted that this should happen. Among other benefits, it provides free childcare and a far more fulfilling environment for the elderly. Part of the problem here is that in many cases the parents will have expected their children to leave home by the age of 21, giving them less reason to reciprocate. And it isn’t the kind of cultural change politicians can easily encourage, unless they want to be branded as social conservatives.
January 5, 2012
Small correction: it happens in other cultures when one parent dies.
January 5, 2012
The real problem is the small costly houses everyone lives in. There no room especially if a large disabled type bathroom is required. Usually both sibling and spouse have to go out to work to pay for the piddly house, so they are not available for caring.
Using the capital from the parents house takes time to put together with the housing market as it is. Also if there is more than one sibling, then jealousy and rivalry becomes a problem.
January 6, 2012
Jealousy and rivalry? What over who gets the house you mean? Just say it, people care more about ‘property’ than they do their parents.
And you can sell a house and its excess contents very quickly if you need to (like say your mother or father are ill) its just that you might not get the price an estate agent says it’s ‘worth’.
If an average house is worth £150k, then invested wisely that should give you£6k per annum income in dividends (which tend to increase), which, plus state pension is more than enough to pay the rent on a suitable house.
A choice between de-cluttering and renting or abandoning/dumping your parents in a home with strangers should really be an easy one to make.
January 5, 2012
My mother-in-law has moderately advanced Alzheimers. It developed rapidly at first so it wasn’t suitable for her to move to be with any of her children, it was best for her to stay in her own home she was familiar with 4 carers a day to ensure she took her medication.
Had she been in England she would have progressed to needing residential care because her condition deteriorated rapidly. 15 minute visits with food left did not really help her at all.
But because she was in Scotland we had access to the fabulous Alzheimers Scotland Infrastructure which allows us to pay for ‘befrienders’ to spend block of time with her. I think it costs us about £17/hour and they get paid about £10/hour or something like that (not sure about those figures). They have a substantial support and training infrastructure behind them but in the main they are people like us who go in on a regular basis to spend time with her. We book chunks of days and also an hour before the bus picks her up for day care to ensure she’s on it.
Several years later she’s still at home, is in good heart and health and is, I would say, better than she was two years ago. Her pension covers her costs so the state is just paying for the 4 short visits a day, which is vastly cheaper than residential care. Everyone is happy.
Why can’t we have this kind of thing in England?
January 6, 2012
it wasn’t suitable for her to move to be with any of her children
Why not? What makes you think that your mother is better cared for by/spending her time with strangers? Sounds a complete nonsense to me.
January 7, 2012
Because her Alzheimers deteriorated so rapidly due to the way it combined with other factors. It was suddenly too advanced to make the transition.
Also we live in tall thin houses with steep stair and no spare bedrooms and at that time we were all working so there would have been no-one in but her during the day + we live a long way from all her friends.
January 5, 2012
The primary provider of care should be the individual and their family. I am uncomfortable with the state taking a helicopter view of intimate topics such as this and plucking numbers from the air on appropriate levels of means testing. If financial support is needed it should be a very local process, with the emphasis on charity rather than state provision.
No-one wants to lose their home in old age, but why should the taxpayer fund an elderly person’s living expenses to preserve a beneficiary’s inheritance? Alternatively, why should taxpayers who have saved carefully be forced to pay for the elderly care of someone who has not saved so carefully?
January 5, 2012
And if you have paid for your care whilst old over your life time, why should the state renege on its part of the deal because its been running fraudulent books?
January 5, 2012
Of salience is where the line is drawn between medical care provided in the home and nursing care provided in the home. If personal assets must pay for nursing care provided in a nursing home it could easily be argued that equivalent care provided in the home must be paid for in the same way. If, as seems likely, it is impracticable to draw a clear line between medical care and nursing care when provided in the home, a perverse incentive would exist to opt to be hospitalised in order to protect the value of one’s estate, rather than opting for the economically and humanly more desirable care in the home.
January 5, 2012
There is one issue I would like to raise and it comes born out of some personal experience and that is the great pressure the NHS puts on families when they want to discharge someone who in the opinion of their family cannot cope in the outside and needs long term geriatric hospital care.
He or she may be sent home in an ambulance, into the custody of their relatives who, totally untrained, are then supposed to try to nurse and care for the person or put them into a care home and pay.
For a person with special needs like dementia, this can cost over £1000 per week and is difficult to find.
My question is, where does illness and the obligations of a hospital end and the relatives responsibility for long term care of elderly chronically ill loved ones begin?
January 5, 2012
Richard
“Where does the obligation of the hospital end………. etc”
Social Workers will try and make that decision for you, if you let them.
See my post 09.47 (not yet moderated).
You have to fight the system which will take control, if you let it.
So in short you need to get clued up as to your rights, and their responsibilities under the system.
In short you have to become more clued up than they are, and quote their rules and regulations back to them.
For example: No one can leave a hospital until the on going treatment is agreed by all parties.
At least that was the case 5 years ago, not sure if it has been changed since.
January 5, 2012
The announcement that council house tenants are to be prosecuted and jailed if they sublet flies in the face of common sense that would help out here. If those who have spare rooms in their council properties because they have become empty nesters are able to let it out legally then they have some basic care in the home built in – and compared with current arrangements, where they can simply under-occupy while continuing to pay a highly subsidised rent. Of course, the rent subsidy should be at least reduced if not removed altogether, but the saving to the state in not having to provide services can also be recognised along with the benefit of reducing under-occupation. Both my grandmothers took in others in their old age – in one case, sisters, in the other lodgers. The key is in setting rents at market rates, and providing housing benefit only to those who need it, rather than attaching the subsidy to the property – something that only barely works for property tied to a particular job (and then only if the property is suited to the family circumstances of the job holder).
Taxation of granny annexes and attitudes towards child minding – requiring official permission etc. are other features that don’t help. Other measures that encourage the atomisation of society and families are also counter-productive. Single divorcees and fathers cut off from their children by the family courts in years gone by simply add to the numbers who end in the care of the state.
While the above are of more limited help when care needs become acute, by improving the effective economic contribution of the elderly they help to reduce the amount of acute care required, and thus make it more affordable for society as a whole.
Attitudes to health have also probably increased the problems. Fewer people are dying “cheaply” – i.e. relatively suddenly – and more are dying of slow acting accumulations of conditions that require expensive care. Research in medicine needs to be focussed on reducing the impact of high cost diseases such as Alzheimers.
January 5, 2012
One needs to distinguish between medical care and living expenses, the costs of the former being the responsibility of the state through the NHS and funded as far as the patient is concerned, by past NI contributions. It seems logical however that the costs of accommodation and food were not part of the deal but it might be difficult to segregate one from the other.
For those who could afford to do so, some single payment annuity bond might be the answer, either furnished by the private sector or as part of a State-administered scheme. For those who truly cannot afford to meet the patient’s living expenses, this would just need to be viewed in the same way as other benefits are managed.
But I stress that medical care surely includes all nursing and concomitant services, which may necessitate provision of at least basic accommodation and sustenance. As such, these should presently be met by the State as part of the welfare contract. That some changes should be made for the future is another matter but any such changes should of course be introduced with a very long lead-in time.
January 5, 2012
I agree will all you say.
My worry is that the NHS is becomng increasingly keen to discharge elderly patients that decades ago would have remained in hospital.
My experience was to watch a 90 year old relative being offloaded from an ambulance on a stretcher, clearly incapable of looking after herself and being left at the door of her closest relative with whom she happened to be living with just before her sudden decline.
Many years ago she would have been moved from the A and E ward into a geriatric ward until she was well enough to manage on her own or to be blunt, deteriorated further and passed away.
My relative, who was also a senior citizen, became ill from the stress, work and worry of trying to nurse someone who really needed the kind of care only a hospital can provide.
January 5, 2012
Richard
This happens because people are unaware of how the system works.
My own mother would have been off loaded into a Nursing home of their choice some 35 miles from her family if I had not stood my ground, simply because they wanted to keep her in the same PCT area as the hospital.
The money follows the patient, hence there is some flexibility in the system, but they do not tell you that at the time.
You have to find it out, and then confront them !
January 5, 2012
There will never be a solution to the “money” problem if all that is considered is the financial aspects of care. There needs to be a far more fundamental analysis.
I think we can assume that, for all practical purposes, no one wants to be in receipt of care. Everyone would prefer to lead an independent life. So if the need for care can be reduced everyone wins.
For planning purposes it should not be assumed that because of increases in life expectancy there will be an corresponding increase in the need for care. There are plenty of people who not so long ago would have been considered “elderly” who now see themselves as leading a rip old middle age. Also, we should not forget that some people who are younger than “elderly” need care.
A factor becoming increasingly significant is increasing life expectancy as a result of medical advances that enable people to get over illnesses that previously would have been fatal. I think we would all agree a good thing. But this needs to be set alongside illnesses that are debilitating and can not be cured, both physical and mental. It seems current trends are leading to ever more people who are not in danger of dying but are so disabled that they need care. If this trend continues then the costs of care will be like trying to fill a bottomless pit.
I suggest there needs to be a reappraisal of funding for medical research as to the proportion spent on fatal and debilitating illnesses.
Whenever I take a straw pole on people’s attitude to their own demise there is always a strong preference for “hale and hearty today and dead tomorrow”. My experience is that the prospect of a slow and lingering decline is not appealing.
Another key factor is the availability of carers. It can not be assumed that as long as you find the money carers can be found to do the job. Caring is not an easy job, and those who are really good are few and far between. The more care needed the more challenging the task. While carers are very much underpaid for the work they do, simply finding more money will not not unearth an endless supply. Caring is as much a vocation as a skill.
So if there is to be an all-party approach with the intention of reaching a consensus that stands the test of time it MUST start with an analysis of the requirements. Solutions MUST include means of reducing the need for care as well as provision of the care that is needed.
Arguing about who pays what is but the tail end of the task.
January 5, 2012
I think there are two parts to this problem. Of course the issue of who pays is important but equally important is the question of why it is so expensive.
Millions of households live on much less than £35,000 per year, so why on earth should it cost that much to provide a single room, meals and a bit of help to a single person? I can even rent a basic serviced room at Travelodge for £30 per night – that’s £10,000 per year. Medical care is an NHS cost, so why on earth does it cost £15,000, (£40 per day) to provide food and a few hours home help to a population efficiently housed together?
This is in the same week when train fares are said to be 6 times the continent’s and town centres are dying partly from high taxes and charges, don’t you see a connection?
Rip-off Britain is alive and well, and I would guess much of the cost is not profiteering by the service providers but down to regulations, licences, inspections, taxes, legal overheads and the like. Why not look at this end of the problem?
January 5, 2012
you would probably get your travelodge room a lot cheaper if you were prepared to book a full 12 months. they already do deals at 10 or 12 pound a night.
obviously depending on location etc.
January 6, 2012
Yes it would be cheaper than £10000 p/a, I was taking a worst case – and the figures still make no sense.
January 6, 2012
Some of this is the result of the kind of financing deals that brought down Southern Cross – effectively property prices inflated to bubble levels.
January 5, 2012
*Why not encourage more people to accommodate their elderly parents in their own homes? Some could use the proceeds of their parents’ houses to buy bigger ones for this purpose. In other cultures it’s taken for granted that this should happen.*
The problem is that the children may work full time.
Someone I know decided to move their mother in with them, but the mother started doing silly things like putting the electric kettle on the gas hob, so full time care was needed.
It would be most fair to take “some” of the value of the property, but not all. Otherwise why bother saving for your old age, and why bother paying off your mortgage, when you can just piss the money up the wall and get given care for free.
If the current trend continues, I am seriously considering just giving up on my mortgage and defaulting, Many people I know get better council housing than what I have to pay double for, and they will get free care in their old age.
What’s the ******* point.
January 5, 2012
maybe see my post above about what’s going on in Scotland fake?
January 5, 2012
Rebecca
Scotland seems to have a better answer to most things than England.
So I give them credit.
But Scotland gets a higher level of tax revenue to spend per person than England, from the UK coffers.
So the answer is, it can probably afford to whilst this continues.
January 6, 2012
The Alzheimer’s Scotland infrastructure we use doesn’t cost the Scottish government anything.
It’s just intelligent planning. There is a strong ideology within sections of this government that believes that the less planning we have the more efficient things will be.
It was rather disturbing to hear Michael Gove accuse his critics of being ideologues in his latest speech!!!! Pot, kettle. We, the critics, are the pragmatists who can actually see the implications of what he’s doing and are just worried. He’s the out of touch idealist.
January 5, 2012
While I agree that taxpayers should not fund social care, the current crop of those in need of care have been duped by the government; it owes them that care. What a pity we can’t extract the necessary funds from the pockets of politicos who duped them.
Andrew Lilico asks:
Why is it a problem if the person having the money spent on her is the one that pays?
http://conservativehome.blogs.com/thecolumnists/2012/01/andrew-lilico-taxpayer-funded-provision-of-social-care-is-not-the-way-forward.html
It’s a problem because:
* Those currently in need of ‘care’ were probably duped into thinking that by paying NI, they’d purchased (if involuntarily) their ‘care’ after a lifetime’s contributions. They weren’t told that their monies only paid for the current crop of government victims – err, taxpayers. In effect, the government voided their ‘contract’.
* Government has scuppered them at every turn – trashing their pensions, taxing their assets and savings via a constant stream of short-term changes that affect long-term planning.
http://bit.ly/wAuKv5
I’m all for self-reliance but it is damned difficult to be self-reliant and to make long-term provision for one’s future when the government constantly pulls the rug from under the feet of even the most responsible people.
Many OAPs have paid for their care 100 times over via income tax, levies, NI, VAT, stamp duty, property taxes/rates/council tax and a host of other taxes, most of which are paid out of already taxed income. Has this redistribution of wealth worked? Has it encouraged people to take care of themselves? Or does the government require still more of our money to throw at the same failed policies?
Has someone done a study on the amount of tax an elderly person has paid by the time he needs care?
http://bit.ly/x5AXU9
January 5, 2012
Our debts are going to get bigger
http://www.voxeu.org/index.php?q=node/7491
See the UK – under current and pre-2008 growth rates our debts will be rising above 100% GDP. Its time to start making the REAL cuts to prevent social unrest being worse in the UK.
According to this Portugal, Ireland and Greece will get out of control. France and the UK are both on a slow slide.
January 5, 2012
“The first is that medical care should always be free, under the NHS” – in practical terms it is not now in numerous circumstances e.g. dentistry, routine eye care, very specialist treatment. I would be most surprised if you really believed this is a sustainable position. Many people prioritise private health insurance in retirement for good reasons. The concept of Beveridge has been distorted to an eventual breaking point.
For me it is reasonable to expect older people to finance their declining years from the sale of their family home. Whilst there are still many families, friends and neighbours who help the infirm and sick elderly to remain in their own homes it seems no longer to be the norm. Most of us don’t want to leave our long term homes and less go into a care home so again I see a route forward in fiscal adjustments e.g. fully transfer spouse tax allowance, result one spouse at home with more time for kids and then elderly parents and maybe free a job for someone else. Specially built apartments, either age restricted to retirees or warden assisted should be encouraged with financial inducements to developers and buyers and people should be encouraged to downsize early. Long term renting of these properties should be made easier and more available. The family and state support groups need to be more augmented and directed in this way. By moving more people early into such controlled environments the care home demand may be eased over time.
I personally would opt for assisted suicide if legal, given the choice was existing in a care home with terminal brain and/or body damage. My guess is that the establishment are not yet ready for this option, but it will come with living wills.
January 5, 2012
This issue is yet another case of unintended consequences i.e. Government deems it fit to intervene to sort out a problem e.g. the nation’s health & sets up the NHS. Fifty years on it’s become a self serving monolith doing way more than was originally intended and being abused by large numbers of the public.
If the public are led to believe that the State will take care of them should we be surprised when they fail to make provision for themselves or via their families.
The only answer to this and many other challenges the nation faces is to get the State out of matters that are the responsibility of the individual and their family. We have to change the mind set that sees millions of people demand their ‘rights’ from the State (tax payers) but refuse to contribute to the system or take responsibility for their actions.
The West’s Socialist system is toast; the emerging economies will not continue to subsidise the West’s profligacy
January 5, 2012
Have I missed a memo that one has a right to inherit a family home?
Personally, I’m not planning my own retirement on the basis of what I’ll get from the previous generation.
January 5, 2012
Let me be extremely cynical here, John.
In view of the plan by Lord Falconer et al for “Assisted Suicide”, there won’t be a need to care for the elderly soon. They propose, amongst other things, that this suicide should be allowed for people who have got one year to live.
With the recent reports on how our elderly are treated in hospital, I think the blatant ageism in our society will very quickly put sufficient pressure on the elderly to avail themselves of this plan.
All the debates about who should pay for what (Dilmot) are so much hot air because this, our society, sees nothing wrong in treating the elderly as useless mouths, as ‘cost factors’. The hatred of the young for ‘baby boomers’, also evident in many comments, fuels this.
Therefore, I simply see no way out of this conundrum as long as the elderly are treated as cost factors, not as human beings.
The message I get from society, in form of the recent reports, is ‘die already’.
January 5, 2012
Viv Evans ….. suicide should be allowed for people who have got one year to live….. I think the blatant ageism in our society will very quickly put sufficient pressure on the elderly to avail themselves of this plan.
Well, I, too, must be cynical because I am sure it will fall to a doctor to say to the ailing person ‘sorry, you’ll be dead in under 12 months, so why don’t you let me help you into the next world now and avoid all that pain and suffering?’
If that comes into being, the next step will be to set targets for doctors to move the elderly along and then, ultimately, someone will rule that the average life-span is, say, 85 and that’s it pal, off you go…. Read a science fiction novel decades ago with the concept of a defined length of life, thought it daft at the time but am beginning to think that sheer economics may well in time bring it about. Frightening to me at 71!
January 5, 2012
I agree with nick , Why should prudent people be made to pay twice, After all this is what all governments would wish, If all the population were prudent and didn’t need looking after (financally) the perfect scenario. So whats the problem in one word POLITICIANS. I would like to see every 5 years an audit published to the public on where our money has been spent and who made what decision so we the public can make a judgement on whoever
January 5, 2012
Means testing should be avoided. It creates perverse incentives, bureaucracy and can lead otherwise honest people to err. MP’s experience with expenses should be a lesson.
How to fund care? Tax and insurance bond payable at state retirement age perhaps?
Currently older working people do not pay National Insurance. Suggestion combine PAYE/NIC into a flat tax with a citizen income allowance (contributor earlier blog post). Encourage downsizing to suitable retirement type facitlities/villages with individual spaces but supported environment -some stamp duty exemptions perhaps. Encourage home care, with transferrable tax allowances and respite care – so carers can have a break.
Regulate the property deals and financial speculation associated with carehome property portfolios. Allow care homes to build/lease/own operate for a term but do not allow them control or sell the freeholds these should stay under public control.
January 5, 2012
The lady next door has spent the last 20 years helping to look after 2 elderly people in the village. She probably spends about 4 to 5 hours a day. Both pay her a small income, for which they get income tax relief, so reducing the cost to them.
If everyone had a citizen income allowance, then many more people could afford to get involved in caring for elderly people around them, on the same private arrangement as my neighbour. The combination of the citizen income and small payments from their elderly clients would give them a viable income.
The state does not need to get involved.
January 5, 2012
Morally, I think its right that we look after old people, and pay for the care for those who can’t afford it for themselves.
Morally, I think its unfair to punish those who saved up, bought property, did the right thing that we encouraged them to do, only for them to lose it all to pay for care and not be able to give it to their kids. They might as well bet their house/savings on horses at age 59, if they win they can easily pay for care, if they lose the state will pay for them like it does to others.
Financially, I am not sure if we can afford all the above, but we should give it more priority than looking after fit and healthy younger people.
Perhaps work fare could include helping the elderly to do shopping, cooking, cutting the grass or whatever. Personally when I was on the dole, this is the sort of work I would have liked to have been doing, providing a service to grateful old neighbours rather than having to do some make-work government scheme or go into a horrible job too soon.
January 5, 2012
Just to point out. I have been saying Unicredit is the weak link the EZ banking system for nearly 18 months. Have help see the mortgage backed CDO debacle safely through at HSBC in the CDS dept and I’ve been just as confident calling the weak point in the EZ debacle at Unicredit – having inferred their books from a number of investment banks trading systems.
Unitcredit have falled by 14% for the second day running – and Im confident to say this is just the begining of the end.
http://www.reuters.com/article/2012/01/05/unicredit-ceo-idUSL6E8C52MN20120105
And I will repeat my prediction of 18 months ago on this site – Unicredit will (damage-ed) Italy and Italy will (cause trouble for -ed) the EZ. I say this even though Greece has just announced it has not got its $bns from the 2011 bailout and had deferred doomsday for 3 months.
Reply: UNicredit has just raised new capital, which lay behind the fall in the share price. The Directors and the regulators clearly think with the new capital it is OK.
January 5, 2012
There are two issues here; the one which most concerns people, I think, is the standard of care in homes. The second, which mainly concerns politicians, is how the costs of care should be divided between state and individual.
The link between these two issues is that a proper comparitive analysis of care quality would distinguish the wheat from the chaff, and decide which homes should be funded either by the state or by individuals. At the moment, the Care Quality Commission provides an insufficiently rigorous analysis for patients and the state to make an informed decision as to where individuals should be placed. Simple things, like fitting up webcams to monitor all parts of a care home for mentally or physically unwell old folk are an obvious first step to transparency. How can a representative from the CQC tell whether a patient with dementia has been fed and watered on a regular basis just be looking at records and asking questions?
There just HAS to be more use of technology and close monitoring to rigorously monitor care standards.
As to who should pay- given that Society has decided that it is inhumane to leave old folk unable to cope for themselves to die in their homes, it is also right for Society to demand an insurance premium from all citizens to cover that cost, but not one which is thrown in a pot with all other taxes. An insurance policy would ensure that all folk who worked in the UK from say age 25 paid a premium which ensured that they would be looked after in old age if required. Anybody starting work after 25 in the UK would need to start paying a premium at a higher rate, if they expected to be looked after here. Alternatively they could pay for themselves here, or would stand to be re-patriated on retirement age if they had not completed paying their insurance contributions.
January 5, 2012
What we need is an asset release system where elderly people can sell their house to an organisation for a fixed amount but are allowed to continue living in this house until they die. Under this system the money from the sale of the house is divided into instalments which are paid to the elderly person on a weekly basis and after the elderly person dies any outstanding amount can be inherited by their descendants.
This would allow the elderly to sell their homes to pay for the cost of their care without having to leave their homes.
January 5, 2012
unanime5
Your solution Sounds like Equity release to me.
It has not had a good press todate.
The Government have already had to tighten the rules because of miselling and poor quality returns and values.
January 5, 2012
Similar schemes already exist, unfortunately most have been ripped off in the extreme by the greed of the bank or other provider.
January 5, 2012
It would have to be an organisation which did not go bankrupt thus failing to pay out and losing the old persons home to their creditors .
Whilst it’s a good idea I think we need to go a whole lot further and establish that land is a natural resource which is collectively owned by the whole country and that the dividends of the land should accrue to everyone by way of a rent paid to the country .
I’m not saying the dividends should accrue equally only a lot more equally than they do at the moment .
January 5, 2012
There are financial organisations that do this already, or have done for some time, but the overheads are substantial. Even if they there is no ‘overcharging’, the costs can be unexpectedly high because responsibilities and risks need to be ‘monitored’ and, as Einstein is supposed to have said, “The most powerful force in the universe is compound interest.”
http://www.snopes.com/quotes/einstein/interest.asp
If I remember correctly, the organisations were lambasted when property prices rocketed as none the ‘profit’ went to the original owner. There is also the risk of property price drops, which will add to the overall cost. Not a win-win situation for the those seeking a solution. Also, the current economic outlook does not make it easy to ensure both parties have an agreeable agreement.
Down-sizing may mean leaving the comfort-zone as well as familiar surrounding, but this is softened by having lower costs, less risk and being able to stay in control of the situation.
January 5, 2012
Interesting but not surprising that Dilnot did not investigate why it costs so much to care for the elderly. It seems to be given in any proposals from the state that costs are high, they will rise and someone has to pay. A better attitude would be how can we provide acceptable services cheaper.
New ideas which enable the elderly to stay in their home would be one basis and providing guidance packs to assist their children to persuade others to move nearer to siblings or children for care would be another.
Whatever changes are made we must get away from the 100% tax down to a tiny level of assets. It is another disincentive to save. Civil servants who retire on good pensions (and MPs) need never worry as their guaranteed income is enough to live on so they can happily transfer their homes and other assets to children and avoid not only IHT but also contributions to social care.
To have imposed these charges after promising cradle-to-grave support and taking the money for it is a fraud. To keep taking the same 50% of national output after stopping the service is shocking.
We need more attention to the supply side here – innovation and lower costs. Is it really impossible to automate any aspect of this? Has paid carer productivity languished at state levels or has it attained private sector improvements? Are the services supplier defined or user configured – I think I know the answer.
January 5, 2012
What is UKIP’s policy on caring for the elderly, Andrew?
January 5, 2012
I can’t give any original insights on paying for it.
My only suggestion is that, as with almost all problems, improving technology helps significantly and that more robotics and automation should be encouraged rather than discouraged by whatever regulation of elderly care is needed (if any of the regulation is). Also that blocks of flats with warm and comfortable halls connecting them (& lifts) are probably better than detached sheltered housing.
January 5, 2012
Once agains with this system, those who have contributed nothing to society and taken benefits all their lives will pay nothing, yet those who have worked, saved and been a contributing memeber of society will get financially penalised. This is socialism at work.
My parent are in their latter stages of life and we have taken legal advice and drawn up new wills and agreements using concepts such as ‘tennants in common’ to protect their assets should anything go wrong. They only live in an ex-council house and have some money set aside but would lose it all if taken into care. Fight back people, there are things you can do !
January 5, 2012
In my opinion the three principles you outlined are entirely right.
I listened to your Today interview. You gave a great performance. What a shame the BBC insisted on ignoring your points about access to care being the main issue and not funding!
The Dilnot report was basically about protecting the inheritance of children of the rich.
January 5, 2012
People should care for older people who need care without asking for money. You should look after your parents when they are in need of it. Moral duty. They helped you when you needed them. In America they respect the old generally.
January 6, 2012
Exactly! Something has really gone wrong when so many people want to dump their parents (or more likely the mother-in-law) on the state and have little or nothing to do with them – just pocket their money.
January 6, 2012
Steven L
I agree, to a degree, but have you ever tried to look after someone with severe dementia, or someone who is bedridden, has double incontinence and is too heavy to lift (even with lifting aids) because none of their limbs work to help you.
Eventually the strain usually leads to a nervous breakdown of the person attempting to care, which means they then need treatment themselves.
In some cases proffessional nursing care is needed 24 hours a day, hence the need for nursing homes in some cases.
January 5, 2012
Ah John….invited onto the Today programme….. I’m sure that you were prepared to be potentially ambushed. The BBC tends to look for opportunities to promote splits in the Conservative party for some reason or other….
It’s not as if you have to say anything…..a raised eyebrow will do. I remember watching a BBC news item when you were being interviewed along with that arch Eurosceptic (sic)….Sir Malcolm Rifkind, and he was extolling his Eurosceptic credentials during the Major administration. After you metaphorically picked yourself off the floor, the BBC guy was straight in looking for the split!
With regards to care for the elderly, I think that any civilised society has to ensure that there is adequate provision for the elderly. I think that the fairest way has to be on the basis of competitive insurance. As Lifelogic said there is still a minority of elderly people who will require care. It is difficult to know if any of us will be in that situation. The costs involved are also a bit of a lottery. To my mind, the fairest way is to assume it as a social risk with competitive provision. The taxpayer would have to pay the premiums of those who are too poor. In my mind, this must go hand in hand with an insurance based (social or otherwise) health system, and not the NHS as currently constituted. Diverse provision from different types of providers would produce efficiency in costs, administration and service.
zorro
There must, however, be proper administration of the scheme to ensure that it is not abused by benefit tourists, foreign nationals or those who have not registered their contribution.
January 5, 2012
An earlier commenter asked why the fees for the domestic services of a care home are so astronomical, when you can get those services from a Premier Inn or TravelLodge for about £10K pa. You could estimate £15K max including meals. I think that is a very good point. It demonstrates that in effect, the medical requirements of looking after residents are being heavily cross-subsidised by the living cost components, because fees of £35K are not uncommon. That Premier Inn comparison is actually quite a good one, you could say that anything that a resident needs, over and above what a Premier Inn would ordinarily provide, is a medical requirement due to disability of the patient, and should be covered by NHS funds. And this differential charging of patients depending on their private assets should not be allowed.
We have provided our own family care to five of our own golden oldies, and don’t regret it for a moment. We would not have trusted care home staff to look after them right. If anyone else fancies the DIY approach, I would say go for it. You will never have to lie awake worrying about whether they are hungry, or thirsty, or left lying in a soiled bed. And there’s nothing in practical terms that you can’t learn to do yourselves. Lots of very helpful aids and appliances abound on the internet.
January 5, 2012
Hello John
Whilst you are thinking about the elderly dont forget those of us British Pensioners living in most Commonwealth countries who, even though we have fully paid up our NI contributions, are having to live with frozen pensions.
My wife & I can now be counted as elderly. We live in Canada having come here to look after father in law. He has since died but we cant afford to come home because of the rise in house prices over past years. Our pensions have been frozen for years and are getting worth less & less. The drop in value of the £ has made things much worse and, like many old people, we are finding things difficult.
If we did come back we would cost the State £s in health care but we would get our pensions uprated each year. Would we get the other benefits that go to non UK immigrants – I doubt it.. Of course, there are many counties which have no ties to UK where we could get pension increases but why should we go there.
January 5, 2012
How about some kind of National Insurance scheme ?
We could all pay into a fund which would be used to look after the elderly in their old age.
We might even link it in with Health insurance.
I know , I know. “The EU will not allow the reintroduction of the death penalty”.
You will all say, “and that will be the only way of keeping Politicians hands off the money”.
Simple. Put the Upper House in charge of the cash, with the power of life or death over any MP who attempts to play politics with it. Leave the EU.
January 6, 2012
People should look after their elderly relatives more, especially if they expect to inherit their estate. My folks are healthy and in their mid sixties, but they are already starting to show signs of age. A few weeks ago my old man (a reasonably savvy retired professional) lost£250 to one of these advanced-fee PPI refund scams – even though he’s never taken out PPI. My mother, who has been involved with animal charities for a number of years, gets about 3 fundraising letters a day now, purporting to represent charities you’ve never heard of.
Professionally I’ve seen cases where all the inheritance bar the house has been transferred to scammers. It’s always the beneficiary that kicks and screams about it, when nine times out of ten if they’d bothered to visit their parents more than once in the last three years it probably wouldn’t have happened.
This whole “someone else should look after them, the government should pay and I should get all their money” attitude is most likely destined to end in tears. Simply living with your parents in their final years and getting home help where needed will improve their quality (and most likely length) of life, and ensure your inheritance doesn’t end up on in the Costas.
January 6, 2012
You obviously have a strong view about looking after your parents. It sounds like you have a space in your house to accommodate them if and when the need arises.
However in 20/25 years time, you will probably be approaching or be in your sixties. Your mental abilities may be reduced and certainly your physical abilities will be reduced. That will affect what care you are then able to offer your parents, paticularly if they have heavy nursing needs.
January 6, 2012
The priciple that the state assists only those whose need its help and the principle that people should feel the benefit of saving for their old age are both important and in conflict with each other.
Of the two I feel it is fairer that people are not penalised for saving for their old age. People react to the rules imposed on them. The idea that the old might be incentivised by the state to blow their saving, to qualify for state assistance, just seems a bit too crazy. Better to have it that saving makes sense and they be allowed to benefit from their life’s labours.
January 6, 2012
Labour completely dodged the care situation, overpaying unqualified entrepreneurs to convert old houses into ‘care homes’. Now care home owners include (some-ed) dodgy dealers, who obviously have a fixed income, and the profit they enjoy is all driven by lowering costs. Which is why we have people not being fed properly, too few staff on hand and people not being bathed or treated correctly.
Making owner or director of a care home criminally liable for cruel or unlawful treatment would be a good step in the right direction.
Reply: Action can already be taken against the conduct you describe. If you know of any such cases they should be reported.
January 6, 2012
Thank you for inviting comments on this immotive subject.
For those of us who have struggled, to gain and buy our own property, it is not right that we should support those who have not done the same. To sit next to a person who may have enjoyed all the freedoms of their wages, drunk, had holidays, and lived the life of riley, and still get it in retirement is fine, but what about those of us who struggled to pay the mortage, paid our dues via taxes, and had no holidays, didn’t drink and smoke, because simply we couldn’t afford to while supporting a family and a mortage. No, I don’t agree that we should pay for those who have contributed nothing or saved or bought property, its most unfair. Labour’s idea of a contribution from all estates upon death is also insulting, I’d desperse mine before they could get their hands on a penny. I’m sorry but that’s how I feel. We are being hit from all fronts, we now have foreigners buying up properties which fall into disrepair, again reflecting upon our house and it’s value. We have fought for years to maintain the property to keep up it’s value where possible, now we are being hit in real old age. This country is becoming grossly unfair to those who strive to help themselves, is it worth it in the end? I feel like selling up and giving my assets to my children and blow the government and it’s policies, it appears the less you have the more you are cared for. The less you do through your life the less you are thought of.
January 6, 2012
Dilnot states that being forced to sell one’s home to pay for residential care is widely regarded by the public as unfair. We should have the courage to say that this is very fair and that those who have a house to sell should consider themselves lucky to live in a democratic capitalist country. Dilnot’s suggestions lead to the view that people should be able to keep lots of money while the state pays for their care. Why should taxpayers pay more inorder that others should get more inheritance?
We should subsidise care for the poor and no one else. Tax incentives linked to savings and insurance policies would be far better than tax and spend. We should not solve with state money the inability to inherit your parents’ house because they become old. Tax breaks for people extending and sharing thier homes to care for relatives and similar taxconcessions for people whose parents retire to share their children’s homes. The more we take the government out of the equation the more we encourage self funded care and family based care.
January 6, 2012
The point that anyone with property should sell because they have assets whilst someone with no assets gets the same treatment free is wrong. That is where it begins and ends morally. The answer does not lie in refusing the facilities to those without means. This is also wrong and part of the continuing race to the bottom of many of the fantasists. This is absolutely unacceptable in modern Britain as is refusal of treatment for lack of funds and starvation due to lack of funds. If you would like to live in such a country then move somewhere else. The one who believe this cannot even climb out from under their stones to be squashed. What does that tell you about how valid their arguments are. Tossers no less. I’ll get back to you.
January 6, 2012
After reading all of the other comments on this page I felt the need to write some more. Many mention the fact who uses the NHS, who should pay for their treatment? This is a very valid point. There are many who use it who should be paying, and these payments could be used for our own elderly patients. Why does any government not stop this abuse of our NHS and it’s systems? We have far to many foreigners using our systems be it the NHS, housing, schools, universities, and jobs, which should be our first port of call for our own. Until we have any government who is willing, or MPs come to that, to stop this abuse it will go on. We on the ground all know it happens, we speak about it, but we are ignored continually. When will the people we elect listen to what we want, and act. There are lots of subjects we speak about but we are ignored. May be it’s now our time for an English spring where our thoughts and ideas are brought to the fore, it’s about time they were. Before this country sinks to low into the mire it’s already in and it’s to late.
January 6, 2012
David Saunders, why should workers be forced to give money to idlers, who have never done a days work to support themselves? And why should this parasitic blight continue to be imposed on the productive, even at the end of their lives, simply because they happen to have some money left that the state hasn’t purloined yet?
The people with the real entitlement in this scenario, are the old folk who have spent the best years of their lives working hard and paying their dues. In my opinion, they are being swindled.
January 6, 2012
Did I miss something? John made no reference to what I understood was a key feature of Dilnot : i.e those with assets would be able to “buy” insurance against the cost of needing nursing care in old age. Given that the market has failed to provide such insurance it seems reasonable for the state to oversee the provision of such a scheme. As always the insurance companies love to have a cap on their liability for an individual but there is no actuarial reason for this. The vast majority of people do not require care for more than two years.
January 6, 2012
The issue of parents who have migrated to remote areas in retirement in order to escape city crime and costs is going to be a problem for offspring.
January 7, 2012
In the last year, my parents have moved from being more than self-sufficient to being in care homes. The people we have dealt with have been excellent and committed. However, the bureaucracy we & they have had to deal with has been horrendous. This has frequently meant that the care provided was what had been needed some months earlier. The financial situation is scary; we have no idea what costs are coming our way; the NHS does not seem to follow normal contract procedures of presenting a quote for signing in advance. ‘Managing the system’ has been a full-time job for my sister for months, and it is my impression that such a role is currently unavoidable if care is to be satisfactory.
January 8, 2012
My mum is a dementia sufferer residing in a specialist care home.
Those in authority were relieved on learning mum would be a self funder and they could not leave me to my own devices fast enough. Thus it was left to me to find a suitable specialist care home, agree fees, negotiate with the Council, sell mum’s home, settle the Council’s Legal Charge in a disputed sum, invest the net sale proceeds, operate a payment scheme and carry out a myriad of other tasks. Of course, had my parents been irresponsible, feckless or immigrants, all this would have been done for mum and neither would she have to fund her own care.
As a self funder mum pays something like a 50% premium over the amount the council pays for the people it places in care. One does not need to ask why.
The issue is primarily the endemic persecution of the responsible citizen who plays by the rules in England. If people like my mother have to fund their care so be it. But Councils must do the same for them as they do for those who have nothing or are new arrivals. Almost as important is the obscene level of stultifying bureaucracy of which North Korea would be proud. Try dealing with that when you are a pensioner!
Notwithstanding that John is a good MP, non of them appreciates the depth to which this country has sunk, and continues sinking, in its unconscionable treatment of those who play by the rules.
England the Gulag for responsible citizens.
January 10, 2012
How about a (voluntary?) national social service year at the age of 18 where young people serve in hospitals, hospices and other institutions for a small wage?
It matures them by a year whilst giving them work ethics and an appreciation of getting old.
As payment, we’d give them the normal benefit level they would get whilst unemployed plus an appropriate bonus for doing stellar work, to spend as they like.
Also, to encourage students, reserve 50% of university places for the people who completed their work satisfactorily, it might even be an idea to add their efforts as a grade enhancer depending on how well they did.