Money money money

The Commission for Social Care Inspection’s (CSCI) report into the state of social care in England paints a grim picture of a system failing many people.

CSCI estimates that more than 250,000 people with care needs receive no services or informal care. Meanwhile, 450,000 older people who do get some care from family and friends and/or state services have a shortfall in their care.

Overall, in the past five years the number of people using council care services has dropped by 27,000, despite the population over 75 increasing in that time by 3%.

The reason why more people are receiving less care is simple; money. Cash-strapped councils are raising the eligibility thresholds for who qualifies for care to try and balance their books. CSCI found that 62% of councils raised their eligibility threshold to ‘substantial’ in 2006/7, with the percentage expected to go higher in 2007/8.

Perhaps stating the obvious, CSCI’s chairwoman, Dame Denise Platt, says “there is an urgent need to create a fair and equitable social care system, which is sustainable and affordable.”

The crux is the “sustainable and affordable” element. To do this will require money – and lots of it. But where will it come from?

Would the government have the guts to raise taxes to pay for increased state care costs? Higher taxation will never be a votewinner and with a general election on the horizon, and poll ratings not exactly stellar, Prime Minister Gordon Brown may be reluctant to do anything that may antagonise voters.

Likewise, while the current means-tested funding system is almost universally disliked – a recent Caring Choices report said that 90% wanted an end to it – finding another system that proves to be popular will be tricky.

It is accepted that people needing care will have to pay for some element of the services they use, but how great a percentage and whether a universal element should be included are hotly debated points. Many older people resent having to use their savings or sell their house to pay for care because they see it as depriving them of their life’s work and their children of an inheritance.

These are just some of the arguments around care funding, and demonstrate how difficult it will be for the government to find a solution that at least some people will be satisfied with.

But while there are some difficult decisions ahead, the government will have to bite the bullet because if they don’t, this situation will only get worse.