A House of Lords Economic Affairs Committee report has said free personal care in England should be available universally by 2025 to 2026, funded through general taxation over a period of five years.
According to the report, "Social Care Funding: Time to End a National Scandal", if the proposals for free personal care were to be implemented, people living in care homes would continue to pay for their accommodation and assistance with less critical needs. Those receiving care in their own homes would not have to pay accommodation costs, which the committee suggested may encourage care users to seek help with personal care earlier on.
The report recommended that a means test for care home accommodation costs be retained and, to avoid "catastrophic accommodation costs", the Government should also explore a cap.
The Health Foundation and King's Fund have estimated that to return quality and access to levels observed in 2009/10, the Government would need to spend £8 billion.
Economic Affairs Committee Chairman Lord Forsyth of Drumlean said: “Fixing underfunding is not difficult. The Government needs to spend £8 billion now to return quality and access in the system to an acceptable standard."
He noted the unfairness of someone with dementia paying hundreds of thousands of pounds for care, while someone with cancer receives care for free, paid for by the NHS. He added: “Fixing unfairness is more complicated but the Government has ducked the question for too long. They need to publish a white paper, not a green paper, with clear proposals for change now.
“We think that change should include the introduction of free personal care, ensuring those with critical needs can receive help with essential daily activities like washing, dressing and cooking.”
The committee's review found that publicly funded social care support was shrinking as diminishing budgets have forced local authorities to limit the numbers of people who receive public funding. According to the report, funding is £700 million lower than 2010/11 in real terms, despite continuing increases in the numbers of people who need care.
The report highlighted how more than 400,000 people have fallen out of the means test, which has not increased with inflation since 2010. This means that a total of 1.4 million older people, or 14% of the population, had an unmet care need in 2018.
The committee said that family and friends, mainly women aged 50 to 64, are taking on an increasing amount of unpaid care, and most carers say this is having a negative impact on their health. Care workers are still underpaid and undervalued, while the number of older people and working-age adults requiring care is increasing rapidly. Meanwhile, public funding is not only not keeping pace but has declined in real terms by 13% between 2009/10 and 2015/16.
The committee also heard how local authorities are not paying care providers a fair price, forcing them to choose whether to market to those people who fund their own care or risk going bankrupt.
National Care Forum Executive Director Vic Rayner said: "The message is clear for the future Prime Minister – adult social care is domestic priority number one...To take no immediate action in the face of this evidence as a new Prime Minister will not serve this country well.”
The King’s Fund Director of Policy Sally Warren commented: "This report, from an influential cross-party group which includes two former Chancellors, makes a strong case for immediate, additional public investment in social care.
"In the longer-term the case for change is overwhelming, and we welcome the Committee’s call to move towards a more generous system which would give more people access to publicly-funded social care as a useful contribution to the public debate."
The report is available at publications.parliament.uk.
Last reviewed 16 July 2019