The cry has gone up from the Opposition parties that the government should reform social care. Labour in office promised to do so but found it too difficult and abandoned the idea. Mrs May in office made proposals which proved to be very unpopular and was unable to find a compromise reform which the Opposition parties liked. It turned out there are as many variants of social care reform as there are political parties. I have never personally pledged to campaign for social care financial reform, and have always been cautious about the subject having studied various plans and seen the degree of disagreement there is about both the objectives and the shape of reform.
Today I am inviting those interested to write in with their thoughts again on this vexed topic. I am particularly interested in what people think the aim of reform should be, as well as in the more normal question of who pays for the care people need?
I have championed changes to social care to improve the service for those who need it. This seems to be the forgotten issue amongst many reform plans. The government does need to set out again clear rules governing the relative responsibilities of care homes and the NHS. Care homes whether private or public sector need to work closely with GPs and the local hospitals to ensure elderly residents have good access to free NHS care as they are entitled to. The NHS should not send patients back to a care home prematurely as some did during the pandemic with bad consequences for the patients and other residents at the Care home. GPs might like to offer – as some do -surgery times at established Care Homes to cover the residents needs as well as making on line consultations and prescription renewal accessible. The local hospital needs good links and understanding with Care Home Managers. There is a temptation by Care Homes to send residents to the local hospital on a precautionary basis where better understanding and contact might allow the resident to stay with GP supervision in the Care Home.
I also wish to see decent standards of accommodation and catering. Where someone is supported by taxpayer money for the living costs in a Care Home the budget should be sufficiently generous to provide a decent standard and good pay for the Care workers. The sums involved may well need to vary around the country as property cost is an important part of total cost and property costs are very variable. A property based supplement to amounts should reflect objective property cost figures by area.
It is also important for Homes to have good programmes of activities for residents for those who wish to join in with them in public rooms or on outings. There must be quality of life as well as security and protection.
It has been a longstanding policy of Labour, Conservative and Liberal Democrat parties when in government that whilst all healthcare is free living costs are not free for those who have private income or surplus capital. Surplus capital includes the value of their own former home if they no longer need it as they are on their own or are going to live out their remaining days in a Care home with their partner. I accepted this policy when my own parents had to go into a care home. I helped them choose a good one and helped them sell their flat to pay the bills. Some now argue that there should be a higher permitted amount of capital that people can pass on to the beneficiaries of their wills. I think most accept that a rich person on a large pension or with substantial wealth should continue to pay their living costs in old age. If the state does opt for a higher permitted capital amount then there will be the need for extra taxes on the rest of us to pay for this alteration to allow the inheritance. Should this line be redrawn?