Peter Carter on the government’s recent green paper on social care.
Earlier this month, the government revealed the most important set of social care proposals in a generation. These ideas will form part of the strategy attempting to plug the £6bn deficit in funding that the sector will soon face. The extent of the funding black hole can be explained with three simple words - we’re getting older.
Over the next 20 years, the number of people over 85 will double and the number aged 100 and over will quadruple. On top of this, 1.7 million people will need some form of care eventually.
The situation in England at the moment is one that everyone agrees doesn’t work. It’s unfair, discriminatory and forces thousands of older people to sell their homes every year. Currently, if an older person has a house or more than £23,500 in savings, they get little or no financial support.
This results in 60,000 older people every year losing their homes, homes they may have lived in for decades with their partner, homes they may have one day hoped to pass down to their children.
According to the government, more than half of people over 65 will need care costing at least £25,000 a year. Importantly, the average cost of care for today’s 65-year-olds is £30,000.
One-fifth of people will require care that costs less than £1,000 - yet the same proportion will need care that costs over £50,000. For those who suffer from dementia, costs can soar to £200,000.
Of course, what most people tend to forget is that no one knows how much care they will need later in life, so it is impossible to realistically save for every cost. What we need is a system that is fair to everyone and supports them when they need it most.
We should also consider the quality of the nursing homes themselves. There is no basic standard of social care, no right to essential treatment nor guaranteed level of support.
I firmly believe that the vast majority of care homes offer very good care to their patients and would not dare breach their individual set of standards. However, trusting that these homes will treat patients as they should is not enough - rules must be laid down and rights given, especially when patients sacrifice so much to be there.
Over the last few years, the government has tried to refocus energy and resources into care being provided at home. Localised care has seen a significant increase in funding but, sadly, this does not solve the problem. Often those at home are very sick and long periods between visits mean that, for hours on end, they are unable to do much for themselves.
The green paper makes a number of recommendations to deal with a sector that can realistically be described as being ‘in crisis’.
One suggestion, labelled the ‘partnership’ proposal, puts forward the idea that the government will pay between one-quarter and one-third of everyone’s care costs, with the person in need paying the rest. With the average cost weighing in at £30,000, the patient will still have to find around £20,000.
The second proposal is called the ‘insurance’ proposal. It works in the same way as the ‘partnership’ option but here the government could help people to prepare for the costs that they would have to face.
Unsurprisingly given the name, they propose this through insurance schemes with both the state and private companies taking part.
Finally the government proposes what it calls the ‘comprehensive’ model. Here, everyone who could afford it would pay into a state insurance scheme via their salary, meaning that, when they need the care, it’s free. This proposal is very much like the current national insurance contributions we all make to pay for the NHS.
Thankfully, the green paper has proposed that everyone has a right to a basic level of care, something the RCN supports wholeheartedly.
However, what must not happen is that a ‘basic right to care’ means ‘very limited’ care for all in reality. This is something the RCN has concerns about and will be lobbying hard for over the consultation period to ensure that everyone gets basic treatment at the right level.
The RCN is determined that not only will people have a basic right to care but also will be guaranteed a good level of nursing care, free at the point of need. This is something we have fought for tirelessly and for us is non-negotiable.
People have a right to free nursing care whether they’re in a hospital or a care home and we will do everything in our power to make sure they get it.
We will be fighting on behalf of nurses and their patients to make sure that this opportunity is not lost, that we see real change and that older people finally get the universal care they deserve.
You can get involved, too. Please join the big care debate by searching online or attending one of the many events up and down the UK. Our time to make change happen is now; future generations will judge us on the action we take.
We are now in the run-up to a general election - the next 12 months are crucial to the future of our profession and the NHS. Together, we can achieve great things for nursing and the people we care for, our patients.