Early in the life of the new Labour government in 1997, it set up a Royal Commission to study the future of long-term funding of older people. Now, 12 years later and after months of delays, the government has finally unveiled the Department of Health Green Paper on the reform of adult care and support in England.
In many respects, the paper revisits recommendations raised originally in the Royal Commission and largely ignored in England. Perhaps unsurprisingly, the Green Paper leaves gaping holes requiring yet further debate. There is a realistic possibility that, before this debate has been completed, there will not only be a General Election but quite possibly, a new government. No doubt we will then start all over again.
But the premise is this: under the present means-tested system, anyone with a home or savings worth £23,500 or more is ineligible for local authority funding, not entitled to receive any help finding a suitable care home, and often shut out from even having his or her needs assessed by social services. This penalises those who have prudently saved all their lives and at the same time provides virtually free care for those without assets. I have worked in the care sector for more than 35 years and still find the system largely unintelligible and most certainly unfair. How is an older person or a relative to navigate these complexities?
I am disappointed that the Green Paper proposals do not attempt to confront a significant flaw in the current system: the absence of means testing of the children of older people. Instead, some children who may well be in a position to help will be able to continue to wash their hands of any financial responsibility for their parents.
Of course there are many children who are unable to help, but those who are should fulfil their moral responsibility and contribute towards the cost of their parents’ care. If they do not, these individuals are then funded by the state and in turn the deficit is made up by homes like Nightingale and, in the final analysis, the community.
Year on year, the problem becomes more serious. Local authorities review their funding levels on an annual basis yet in many cases the true value of their contribution actually decreases. They often fail to stay abreast of inflation even at current, unprecedentedly low levels. For the Jewish community, this has further implications. Although legislation regarding funding of older people refers to the right of residents to have culturally sensitive provision, e.g: kosher food, no allowance is made to cover these increased costs.
As longevity increases and, for the first time in Britain’s history, pensioners outnumber children, the need for change is urgent. We cannot continue indefinitely with a system that is muddled and not transparent.
Local authorities cannot expect charities simply to absorb more and more of the financial burden, and children must react to their parents’ care needs appropriately and proportionately to their financial situation.
Nightingale would never turn someone away for lack of finance. We are a charity that exists to care for older Jewish people in need. Our care homes are a beacon in the sector. Together with the community, we need to safeguard their long-term future.
Leon Smith is the chief executive of Nightingale care home
