Free care at home: is the government really listening?
Today we have learned that the government plans to introduce a Bill that will ensure free personal care at home for a number of older people and disabled adults. Crucially, this will not be means-tested, but instead offers the prospect of care based solely on an individual’s assessed needs, regardless of income. It is undoubtedly good news for those people who want to access care services at home. It is likely to reduce the numbers who feel pressurised into residential care and subsequently lose their savings – and often their homes – as a result. For years the sector has campaigned to get social care higher up the political agenda. And here we are, with personal care tipped as Gordon Brown’s flagship domestic policy for 2010. Not only that, he must view social care as a potential vote winner, with a general election just round the corner.
But I’m confused. The government has only just finished consulting on its Green Paper on the future of adult social care, which sets out a plan of action far more complex than what is presented in the Queen’s Speech. Andy Burnham, Health Secretary, has commented that the new bill would be an ‘interim measure’ – something to help people out whilst the final decisions are taken on the ‘National Care Service’ of the future. But in a system that already baffles most who come into contact with it, does the government’s decision not just add another layer of complexity that will ultimately make it all the more difficult to initiate full-scale reform? It could be enough to make some of us a little cynical about the whole consultation process surrounding the Green Paper. Political expediency over the sector’s views? Now there’s a thought!
I also wonder what this bill says about the nature of residential care. Current policy discourse tends to promote the idea of ‘independent living’ as meaning staying in your own home. This is what is ‘normal’; this is apparently what we all want for ourselves. But for some, staying at home can become a lonely existence in older age. So whilst acknowledging what is good about this bill, let’s not forget that we should also be striving to ensure that people receive quality care in residential and nursing homes too. And this must also be central to debates about adult social care funding.
November 18th, 2009 at 9:40 pm
Also if the ‘free’ home care is restricted to those with ‘critical’ care needs, you are narrowing the eligibility enormously. There won’t be that many that qualify. But it makes for a pleasant enough headline.
November 19th, 2009 at 9:06 am
I agree with your point about residential care. For many people, living along would be undesirable and would undermine wellbeing.
Electioneering is largely focused on the swing voter. Are older people the swing voters in the next election? Are they to be the battleground?
November 19th, 2009 at 3:33 pm
What is important here is avoiding the one-size-fits-all solution. Some older people will require nursing care and others residential care. Those who are happy to live alone may occasionally need support at home, especially in the event of short-term sickness. And for those living with their families, respite care (and an income!) should be available for the carers. Brown’s ‘solution’ may look like electioneering but according to the Daily Torygraph, Cameron’s £8,000 brainwave is badly thought through and could result in some older people having to sell their homes and go into care. Article here: http://bit.ly/ZSQEg
November 20th, 2009 at 10:59 am
Thanks for this link Michael. I hadn’t appreciated that the Conservative’s insurance scheme was tied solely to residential care. I am finding this binary between residential and homecare increasingly bizarre – especially now that specific forms of care appear to be linked to different political parties. It’s not helpful and it doesn’t reflect people’s experiences. We all just want good care – for ourselves and for our families – when and where is makes sense for us. And a comprehensive system should be able to ensure this in a way that is equitable.
November 21st, 2009 at 8:10 pm
My instant reaction was the same as cb’s – that it’ll just intensify the trend of providing care only to those who need the highest levels, leaving most people ineligible.