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!

Adam Webb

About Adam Webb

Although originally a physicist by background, Adam soon realised he was “more interested in people than particles” and has spent the last ten years working in policy and project roles in adult social care to support operational staff. Starting his career a few months before Our Health, Our Care, Our Say was first published, Adam has observed with great interest as personalisation and integration have evolved, and been implemented with varying degrees of zeal and success, against a backdrop of demographic pressures and shrinking budgets. As a self-confessed geek who has always been involved in the technical side of things, including charging and resource allocation, Adam will be blogging about developments around the cap on care costs and changes to capital thresholds (‘Dilnot’), which are (were?) due to come in force from 2016. Adam is enthusiastic about the Care Act, because it has finally enshrined personalisation in law, achieved parity for carers and re-emphasised the need for transparency and due process, but feels it is not without its challenges, particularly given the budget difficulties facing all local authorities today. He is particularly interested in how local authorities have gone about implementing the new eligibility criteria, carers’ rights and independent advocacy, and hopes the Care Act has heralded a new dawn for those of us who may need support.

2 thoughts on “The Dilnot denouement”

  1. Mary B

    The potential administration costs alone of the proposals were huge, so yes – a collective sigh of relief across adult social care. This was never going to affordable for local authorities. However, is it worth highlighting that the £72,000 cap was always a bit of a myth? This cap was only ever for ‘care’ and not ‘hotel’ costs, and only at the local authority rate. In reality people would still have been paying significant sums over £72,000 for their placements. At the risk of being provocative, is this necessarily a problem – if people have significant amounts of capital why should they not contribute towards the costs of care – should it be a priority of government in these times of austerity to protect the inheritances of the few at the expense of supporting the most vulnerable.

    1. Belinda SchwehrBelinda Schwehr

      Thanks for the comment Mary. I do think that one of reasons the policy was hard for people to understand was that it was hard to characterise – I could never decide whether it was so right wing that it disappeared around the back to become leftish, in the sense that it transferred risk to the State in order to smooth out unpredictable high level costs for a 1 in 10 section of the population – or so out there in terms of neo-socialism that it became right wing, in the sense that it was going to involve central government controlling the cost of care, by virtue of incentivising people to let councils do their buying for them, and thus becoming uncontrolled monopoly purchasers. The policy was multi faceted and think that one of the reasons it was geared to protecting people’s assets is that any government still needs to encourage people to work hard and save, and it was trying to lay off the risk that none of us knows whether we will need care. Protecting the inheritances of the few seems to be precisely what canning Dilnot has enabled the government to do, mind you, since the inheritance tax threshold has been put up to £1m per couple!

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