Category Archives: Finance, Dilnot and Deferred payments

The Dilnot denouement

In my previous post I suggested that all the signs were there that Dilnot would be put on hold. Yesterday our suspicions were confirmed as a letter from the Care and Support Minister to the Conservative Chair of the Local Government Association’s Community Wellbeing Board, Cllr Izzi Seccombe, stated that Government would delay, until 2020, the implementation of the cap on care costs, the duty on local authorities under Section 18(3) of the Care Act to meet the eligible needs of self-funders in care homes and the appeals system which was proposed in the consultation earlier this year. It is important to note, however, that there was no mention of delaying the increase to the capital thresholds, above which people must pay the full cost of their care from their assets, to £118,000 for those in residential care and £27,000 for those in the community from April 2016. All bets are off about that!

The reasons set out by the Minister for this decision were that the cap should not be implemented in isolation, but in a way that ensured a sustainable health and care system, and that concerns expressed by Cllr Seccombe, on behalf of the LGA, which represents all England councils, and others, including the National Audit Office, had ultimately led to the postponement of Phase 2 of the reforms.

The news spread like wildfire as news outlets picked up on the story, and it was even announced on news bulletins – notable in my view because social care rarely hits the headlines – but this goes to demonstrate the high profile of this element of the reforms as stated in my previous post. Seccombe warned on the Today programme that councils were already struggling with budgetary pressures and the second phase of the Care Act would need to be fully funded, otherwise these pressures would begin to be shunted on to the NHS. This echoed the concerns she had expressed in a letter to the Health Secretary on 1 July, in which she suggested that the money allocated for implementing Dilnot should instead be used to plug the £700m shortfall councils were already facing in social care.

A collective sigh of relief will no doubt have been heard in councils across England, not because it was felt that the Dilnot reforms were a bad thing in principle, but because of the implementation issues councils have been grappling with, and uncertainties about the true costs of the cap. However, if the aim was to bury this controversial news on a quiet Friday afternoon (it was a Conservative manifesto pledge that people would not pay more than £72,000 towards their care from April 2016), Ministers will be disappointed. Former LibDem Health Minister Norman Lamb branded the announcement “an outrageous betrayal” of the electorate while Liz Kendall, the shadow care minister, called it “a shameful broken promise from David Cameron, and devastating news for older people and their families who have been trying to plan for the future”.

Putting back the Dilnot reforms indefinitely would have been a very brave thing to have done, considering it was the Conservative-led coalition government which had originally asked the Dilnot commission to review the funding of care and support in England, but putting the implementation back until the next Parliament (rather than the two-year delay the LGA had suggested) is for all intents and purposes the same thing.

In my next post I will be looking in more detail at the implications of the announcement for individuals who may need care and support, self-funding or otherwise, and their families, and the sector. Stay tuned!

Dilnot or not? That is the question!

Until fairly recently, the parts of the Care Act that ultimately resulted from The Dilnot Commission recommendations, may not have been foremost in everyone’s minds. Some of us will have been so busy preparing for the implementation of elements of the reforms such as the new eligibility regulations, the independent advocacy duty and carers’ rights in April this year, that we have put the second tranche of the reforms to the bottom of our To Do lists.

Many people will have heard of the cap on care costs of course, due to come into force in April 2016, a year after the rest of the Act; after all, it’s been in the news a fair amount, and arguably has enjoyed a higher public profile than any other aspect of the Care Act – not having to sell one’s home in one’s lifetime is a major selling point, is it not? Well, like most marketing headlines, the detail is really in the small print: it is interesting to note that as far back as two years ago, the care Minister and Department of Health admitted that only a small minority of people will benefit from the cap.

Originally it was promised that the detail of how Dilnot would be implemented would be published last October or November. Finally in February this year, Government published another consultation, this time on draft guidance and regulations for the cap on care costs, and proposals for an appeals system, which finished eight weeks later on the same day Parliament was dissolved before the general election. One cannot help thinking that despite the undoubted hard work that has been done by the Dilnot Commission, the Law Commission, the Department of Health, and across the sector over several years to pave the way for the biggest reforms to adult social care in over 65 years, the end result has been something of a rushed job.

Ongoing concerns about the affordability of the reforms, voiced not only by councils, but by national charities and providers, serve to further dampen people’s optimism about what on the face of it is a fantastic, progressive piece of legislation. It was interesting to note then, that in the Summer Budget on Wednesday 8 July, there was not a single mention of the Care Act, but perhaps there WAS a clue about the Government’s intentions in the fact that the couple’s inheritance tax threshold will be increasing to £850,000 from 2017. In 2013, the Health Secretary told Parliament that the cost of implementing the cap would be met in part by freezing the inheritance tax threshold at £325,000 per person for a further three years from 2015-16.

Two days before the Summer Budget, on Monday 6 July, the Guardian ran a piece which said that senior figures in the social care sector say the idea of “pausing” the cost cap, due to be brought in next April, is being discussed urgently in Whitehall. According to journalists, we will know the outcome before Parliament rises for the Summer on 21 July – no doubt when journalists go away on holiday too.

For those Councils up and down the country, which have been grappling with issues such as how to manage an increase in needs assessments, or an influx of complaints about the sufficiency of someone’s Personal Budget, let alone how they are going to pay for it all, it will be a long few days.