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Thursday, 22 September 2016

Means-testing excludes too many - cuts have made elder care today look like the Breadlines of the 1930's and 1940's

Reductions in central government grants have put increasing pressure on companies and authorities who provide residential, domiciliary and nursing care services. This means social care is now dominated by a private sector which too often either isn’t working to best look after those who need it, or to make the profit the system now necessitates.

Older people and their families have been “left to fend themselves” as the social care system in the UK slips into an extreme crisis, according to a recent published report by The Kings Fund and Nuffield Trust.  After years of warnings about major demographic change and rapidly rising need, including from people using care services, it is hardly surprising that the new research from the King’s Fund and Nuffield Trust says the next five years “look bleak”.

Since 2010, the government have committed themselves to a "leaner, more efficient state", draconian public spending cuts in the name of “austerity” and swingeing reductions in local government budgets.

The social care system is clearly failing to meet the needs of older people and causing damage to them and their families.

It has badly damaged the NHS, which is now considered to be increasingly undermined by the failure of social care to ensure community support. As a result, there are problems of wasteful and damaging emergency re-admissions and “bed-blocking” – where elderly people remain in hospital instead of receiving appropriate care.

The large care home provider Four Seasons Health Care is currently struggling under a burden of debt and in June a committee of MPs warned that “there is a real threat that many care providers will not survive” because financial conditions are unsustainable.

The King’s Fund report contributes detailed evidence from national data and local case studies showing just how bad things are. It says that over the past five years, local authority spending on care for older and disabled people has fallen by 11% in real terms, and the number of people who received state-funded help had fallen by 26% despite the numbers needing it increasing.

Public spending on adult social care is set to fall to less than 1% of GDP by 2020, with a predicted funding gap of £2.9 billion by 2019 and many councils struggling to meet basic statutory duties.

One million people with care needs now receive no formal or informal help – a rise of 10% in a year. The report also notes that over 40% of money paid to care homes came from people paying for themselves.

The current criteria of means testing excludes too many.  Under the current system, if you have assets or savings of less than £23,250 then the government will help pay for the cost of your care. This means that only the poorest get help to pay for services, including help in the home for daily tasks such as washing and dressing, as well as round-the-clock support in care homes and nursing homes.

Means-testing is excluding more and more older and disabled people with support needs. Ever-narrowing eligibility criteria mean support is increasingly restricted to people in the most extreme situations who fall under the categories “critical” and “substantial”, undermining all efforts to build prevention into the system.
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