NHS Confederation paper argues for fairer social care funding through a social insurance model
Tuesday, 22 April, 2008
Social care funding must be fairer if provision of social care is to survive, according to the first in a series of debate papers published today by the NHS Confederation in the run up to their annual conference.
The long term solution to society’s biggest problem – how to fund social care for older people – could be a minimum package of entitlement paid for through a new insurance system, according to Funding tomorrow today.
The paper argues that it is not sustainable to expect increasing numbers of people who have worked and saved all their lives to sell their homes to pay for care.
Relying on our children to fund the care of increasing numbers of elderly people and people with long term health problems is not a realistic solution. Instead, a new relationship between the individual and the state is needed that recognises the need for extra resources and organises funding fairly.
A new system of a sensible level of care backed up by top-ups through social insurance and government support for the poorest would reward those who save, favour prevention over high cost ‘last resorts’ such as care homes and hand control of how money is spent to the users rather than the funders of care.
Commenting on the paper, NHS Confederation Chief Executive Gill Morgan said:
“We all have to face up to the issue of who is going to look after us if we get sick or grow old. There is a widespread view that the current system cannot be sustained and will require a constant series of legislative changes.
“The current system is also seen as unfair. It cannot be right that many people who have saved or invested money wisely feel penalised through, for example, having to sell their homes to pay for care in their old age or if they get sick.
“Decisions around the care of the elderly and the long term sick cause genuine heartache for frontline NHS staff. A system of social insurance that guarantees a level of care to the elderly and sick in keeping with the NHS’s values of fairness and social justice with top ups for those who can afford it and support for those that can’t offers a fairer way forward.
“We do not claim this paper is the only answer or indeed the right answer. Rather it is a provocative attempt at setting out the problem and offering an alternative solution based on the latest thinking and the experiences of other countries.”
Key Points:
The current social care system is unable to deliver targeted social care to all those who could benefit from it, let alone universal provision.
The solution could be found in a social insurance system which removes the disincentive to save while helping the poorest.
Social care users are currently small subset of the population who have little voice and not much choice.
If services need to be individually tailored, they will have to be much more directly accountable to users.
Elsewhere in Europe, the benefits and income support system are better connected.
The blurred and hard-to-define line between nursing and social care for people with long-term needs has not been addressed adequately.
The NHS Confederation futures debate series is designed to stimulate new thinking on future challenges to the health service. The papers will feed into the NHS Confederation annual conference and exhibition, Delivering the future today, with debates on the issues raised in the papers. Find out more about the event at www.nhsconfed.org/2008
Three further papers will be published in the lead up to the conference, including: compassionate care (May), globalism (June) and disruptive innovation (at the conference).
You can join the debate by contributing to the forum at www.debatepapers.org.uk
Here you will be able to read the papers and leave comments which will influence the debate at conference.
