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.