Ministers have confirmed they cannot commit to a cap on the cost of social care until 2015 – and suggested the amount patients have to pay could be higher than the level recommended by an independent review of care funding.
The white paper says the government accepts in principle a cap in care costs, as recommended by Andrew Dilnot’s independent commission a year ago. Ministers said they will work to introduce a system of loans from councils to pay for residential care by April 2015. Ministers will also bring in a national threshold setting out eligibility for care at the same time.
However, a “progress report” on funding reform published alongside the white paper said “there are a number of important questions and trade-offs to be considered”. A new funding model will only be based on the Dilnot principles “if a way to pay for it can be found”.
“The government is unable to commit to introducing a new system at this stage. Funding reform needs to be considered alongside other priorities and the right place to do this is at the next spending review. A final decision will be taken then”.
The next review is expected in 2015.
The Dilnot Commission suggested care costs be capped between £25,000 and £50,000 per individual. But the progress report says: “There was a discussion of the level of the cap, with some people suggesting that a cap could be set at the top of the commission’s range – or even slightly higher (eg at £75,000) – without undermining the principles of the system.”
The DH has run calculations for the effect of a cap of £100,000, and has used that model as the assumption for some of its further analysis.
The report says “the financial services industry” had said the “most appropriate level for the cap” might be higher than the Dilnot recommendations.
Ministers are also considering an “opt-out approach” to the scheme. The report said: “One approach would be to implement a voluntary scheme which people could opt into or out of.
“People could individually make the choice to be protected by the capped cost scheme – and only people that opt in would pay the cost.”
The paper also includes commitments to improve the quality of care. Councils will be required to use a “diverse range” of care providers to ensure patients can choose.
They will also rule out “crude contracting by the minute”, arguing this can “undermine dignity and choice for those who use care and support”.
The paper sets out aims to bring in a new code of conduct and minimum training standards for care workers, and to double the number of care apprenticeships to 100,000 by 2017.
The white paper will now go to consultation. Ministers have said they will work with the opposition on the plans.