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Q&A: what the long-term care reforms mean for you

The government has announced a shake-up of care and support for the elderly and disabled. It has not said how it will be paid for but fewer people will have to sell their homes while they are alive.


by Michelle McGagh on Jul 11, 2012 at 15:10

Q&A: what the long-term care reforms mean for you

The government has published its long-awaited paper on how the provision of long-term care for the elderly and disabled will be made fairer.

The Care and Support White Paper and draft Care and Support Bill is being heralded as the biggest shake-up of social care reform since the 1948 National Assistance Act. It aims to consolidate a number of different laws to create ‘a single modern statute for adult care’, according to the Department of Health. 

But what does it mean for those who require care and those who care for them, and how will it change the current situation?

Why do we need it?

People are living longer, which is good news. However, figures from the Office of National Statistics show the number of healthy retirement years is not rising in line with the increase in life expectancy. Men and women who retire at age 65 can expect to spend 56% and 57%. respectively, of their retirement in good health, and 58% and 55%, respectively, of their retirement free from disability.

If the average person only has just under 60% of healthy years in retirement, then the other 40% will be spent needing some form of care.

As people live longer, the number of years people will need to be cared for increases.

Two years ago economist Andrew Dilnot was tasked by the government to find solutions to the care crisis. He proposed a number of changes, including capping the cost of care for individuals at £35,000 and increasing the means-testing threshold for care to £100,000 – currently anyone with assets worth over £23,250 cannot get state help with care costs.

So what does the white paper propose?

The government has proposed a number of reforms. Please see the links to government factsheets with more information.

1. End of the postcode lottery
Currently, councils set their own eligibility criteria for social care meaning that the level of care elderly and disabled people receive, and the support their carers receive is a ‘postcode lottery’. See the Assessments and eligibility factsheet.

The government has pledged equal access to care and support across the country with the introduction of national standards that all 152 councils in the UK will have to work to.

2. Defer care costs until after death
Loans will be offered by local councils to help cover the costs of care. These loans will then be paid back from the estate of person in receipt of care when they die.

The policy will stop the need for people who are not entitled to state help to sell their homes to pay for care. Each year, 40,000 people sell their homes to pay for care. Taking out a loan will allow property to be kept in the estate, although interest will be levied on the loan when it is recouped by the council.

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25 comments so far. Why not have your say?

The Wills Man

Jul 11, 2012 at 18:15

Fine words - we all await the procrastination that will surely follow....

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Dave M

Jul 11, 2012 at 18:19

So, buy your own house with no state subsidy and we will take it away, while those who did not will get free care. What is the point of a loan to keep the house once you go into care? It is unlikely you will get better. So, you still can't leave it to your kids.

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Jul 11, 2012 at 18:27

So what's the point of being careful all your life, making sacrifices to pay for your house, putting money into a pension fund and keeping holidays to a minimum to leave your kids something. I might as well of gone out enjoying myself every night, paid nothing into a pension fund and rented a house, then if I need to go into care the state will pay for it.

These proposals solve nothing.

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A Murray

Jul 11, 2012 at 18:34

The sad fact is that there is plenty of money, but it is profligately wasted by unaccountable and irresponsible quangomania! Simply capping ridiculous legal aid and payouts for slipping on a banana skin and the like would save half the budget, and cutting all tax-payers money paid to union reps - members fees should pay for them like all other clubs associations and organisations - plus cutting all council jobs concerning 'sensitivities', would certainly allow monies to be directed effectively, responsibly, and be representative of the genuinely needy. It seems that selfishness and greed are the biggest barriers to spending the tax payers money wisely.

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Peter Paddon

Jul 11, 2012 at 20:05

So, when one person in a partnership has died and the second needs care in a nursing home, the house is left empty to deteriorate?

I'm going to gift my kids some money when I retire tell them to invest it and give me the income and pray they don't get divorced.

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Jul 11, 2012 at 20:10

Rent a house and give your money to the kids.

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clive chafer

Jul 11, 2012 at 20:39

I think that A Murray is spot-on. The money is there but being wasted on various bureaucracies like 'elf an' safety (whose work is already done so could be disbanded forthwith) and the crazy legal aid maze where 'legal teams' are apparently available to mount spurious appeal after spurious appeal for assorted undesirables. Then there are the fortunes being paid by taxpayers for interpreters for all and sundry.

Such things are almost certainly the tip of the iceberg yet something really important like the Dilnot proposals fall at the first financial hurdle. It is quite pathetic.

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Hilary hames

Jul 11, 2012 at 20:49

My husband and I are both 65 so very interested in all this. I would have prefered the option of an insurance policy but its unlikely to happen

Its daft, as already said, for houses to be left empty and rotting but I suppose thatthey can be let. At least if you have a loan you do not have to worry about periods of non occupancy between lets

I am hopeful that my generation will not be too burdensome on the state. Most of my friends who do not have their children nearby are considering moving closer to them and also downsizing into managed accomodation where there is beginning to be more choice of size and facilities than just the standard McCarthy and Stone with a residents lounge. So with a bit of luck, stroke or a major degenerative illness apart we may manage till the very last year or two of life if we have sensible housing with like minded people around and a caring family

My mother did not think like this. She refused to budge from the 3 bed semi she lived in with my dad for 50 years. She was fine tilll she was 93 then she broke her hip and did not regain her strength. She lived 50 miles from me and so had to go into a home. We couldnt let the house out because she needed new kitchen, bathroom etc etc. It wasnt shortage of money that stopped her doing stuff in the house, she just couldnt face the upheaval. I just cannot imagine being like that, I have already lived in five different towns and houses!

What does annoy me is that private buyers of residential and nursing care subsidise those that the council pay for by several hundred pounds a month in some places. I suppose the suppliers argue that the councils buy care in bulk.

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David Harvey

Jul 11, 2012 at 20:59

I thought we were all going to need to pay 9000 quid and would be sorted. This still seems to encourage people to spend everything they own before it's too late. Again it could make saving for old age a waste of time for many bands of society. You still can't pass your house to your kids and those who rented are better off. Pretty much same old thing really, no solution to anything.

A Murray is right and there are more examples, there are a number of set ups that were working fine but for some bizarre reason someone decides it needs an expensive re structure to justify their salary, after making sure they have a place with in it of course.

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Jul 11, 2012 at 21:14

We need a system that spreads the costs of care amongst as many people and over as long a time period as possible. This will have the effect of minimising the payments.

Such a system is already in force, to cover the cost of the National Health Service, national insurance contributions. It is the fundamental principle of insurance ' to spread the cost of a few amongst the many'.

I'm sure an actuary could calculate the amount that national insurance contributions would need to be increased by to meet the cost of care for those in need. The system is already in place, so set up costs would be minimised. Understandably people are reluctant to see the value of their estates denuded by the cost of care. I think most people would find that it is much more acceptable to spread the cost over a lifetime. True, not everyone will require the care but the same applies to NHS treatment.

Everyone of working age would contribute to the fund including the self employed, together with those drawing benefits and those on retirement income, thus making the scheme as equitable as possible. It will get us away from the argument that some pay and others do not

The scheme would be in a position to provide funding for those in need immediately. I do feel that it would be only those people who already have a reasonable national insurance contribution record that should be eligible, otherwise we will be exposed to 'care migrants' in the same way that we are to health tourists. If people see that a scheme is fair they will back it.

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Peter Paddon

Jul 11, 2012 at 21:15

Sad to say that the savings identified by A Murray are all relatively small and although useful, are a mere drop in the ocean compared with the overall cost of care provided by government and councils. The thing that really gets me is that this was all entirely predictable and long time ago and the issue was ducked by successive governments. Trying to resolve the issue against today's economic background is seeing it kicked into the long grass again. Eventually someone will have to sort it and the cost will be greater than it is now.

The long term answer has to lie in some form of insurance or as part of your pension. Possibly we will see the end of pension tax relief and the notional relief going to fund a care insurance policy. Life is going to be more expensive for our kids which ever way we look at it.

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Jul 11, 2012 at 21:26

Surely the best course of action for a young person starting out in life is to rent council accommodation, take the subsidy that goes with it, spend every penny they get then get looked after by the State (ie, us) for the rest of their days. That way they take for the whole of their lives while, this being a zero sum game, the rest of the population give for the whole of their lives (through taxes, care home fees and, ultimately, inheritance tax on anything that might be left). This is wholly in keeping with the policy that encourages benefits tourists to come to this country and take as much as they can get while the deserving poor here are largely neglected. It must be acknowledged that politicians in this country have produced the most extraordinary upside down state of affairs!

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Bill lawson

Jul 11, 2012 at 23:10

With a bit of luck this proposal will go the same way as many recently introduced and abandoned .

If the government wish to carry on giving free care to those that cant afford it they should provide council run care homes that are not a big drain on tax payers past and present , £800.00 per week and rising is too much to pay for care of one old person ,thats more than £40000.00 per year,

The house value would be used up in no time and if left to rot would be worth even less.

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Jul 12, 2012 at 10:27

It is not the job of the taxpayer to protect other people,s inheritances.

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David Harvey

Jul 12, 2012 at 20:52

This is such a massive subject and has repercussions for us all.

The percentages shown make it all seem so logical. The reality is to do with the 'apparent' health of people and wishful thinking. Fit to live and fit for work. There are so many that will now be looking for extra work that will not be fit for it. We have people with physical disabilities, people with learning difficulties, people with mental health issues, people with little or no education, the downright unwilling the list goes on and now we add millions of elderly to the list. How many greeters do they need at supermarkets anyway?

Most of these people will not have been able to save but will need social care and will either get it or suffer and die. Those who have bought a house have to now lose it to help pay for all of the above. Are we not sending the young generation a bad message? Don't save don't, buy a home, don't get a pension. They are already put off by recent reforms which show clearly that nothing is sacred even your pension or retirement. Are we prepared to say if you haven't got any money you will be left in pain or cold or hungry or die?

In our hatred of all things public sector we may have thrown out the baby with the bath water. I have said before that privatising will make social care much more expensive. I am finding that it is having another effect in that like the railways it is becoming not only expensive but fragmented and impossible for most to use. I spoke with a lady trying to care for her mother today and she had a list of a dozen names and numbers each a different part of what used to be in one place. The other question is that without her daughter as advocate she would just not get the care because she couldn't cope.

Many organisations function on volunteers but most of them, as you can see at your hospitals, are ladies who have retired early. They are now gone or going! Where will the Big Society come from now?

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Jul 13, 2012 at 00:01

This really doesn’t change the landscape. Currently if you have a dependent living in your home (spouse) the local authority can’t force you to sell it but will look to get money from the sale of your property when the spouse dies.

If you are alone and go into a home and your property remains empty, you currently rack up bills and they can recover those costs from the sale of your home when you die. Which yes might be worth less as it has been empty for 3 years.

So now they propose that instead you can get a loan – with interest, and pay for your care up front, then when you die and the house is sold the loan is paid off from the proceeds of the sale. The only difference I see is now the local authority has a legal hold over your property by giving you a loan against it, making it easier for the council to get its money.

This does not benefit the person in the home but aids the local authority.

Having been through this now I loathe the all or nothing cliff edge there is, worse than that someone with no assets has the care home paid for whilst still receiving a state pension, getting free food, electricity, heating, winter fuel allowance They give money away. Don’t get me started……

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David Harvey

Jul 13, 2012 at 09:24

This was all going to be cured by another of those pre election yarns he made, everyone pays a fixed saveable sum. This could have been done like as a special account set up through a lifetime that once paid into couldn't be taken back out, even the poor could cope with it over a life time as it caught tax free interest.

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Anonymous 1 needed this 'off the record'

Jul 14, 2012 at 17:55

Sometimes the shortest comments on here are the most incisive. Well said Tortoise:

'It is not the job of the taxpayer to protect other people's inheritances'.

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Jul 14, 2012 at 18:44

equally it is not the job of the taxpayer to keep somebody who can't be bothered getting out of bed in the morning or saving for their old age.

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David Harvey

Jul 15, 2012 at 08:28

Is it the job of people have inheritances to pay for those who don't with it?

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clive radley

Jul 15, 2012 at 09:07

Those of us who are retired and are home owners have benefited hugely from house price inflation. I bought mine for £65000 and it's now worth £265000. So if sold there's a large profit. It seems very fair that the profit should be used to pay for nursing home fees if I need to go into one.

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Bill lawson

Jul 15, 2012 at 09:23

If the price of ENERGY fuel etc was brought down this would reduce the price of food , the main comodity us old people require ,this would solve the problem of massive inflation and stop the LSD becoming Lyre and pence

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Jul 15, 2012 at 22:56

Sometimes the shortest comments on here are the most incisive. Well said Palace50

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john brace

Jul 17, 2012 at 09:48

i also agree with Palace50 - also Sage.

The answer is a slight tax increase [pensioners pay tax too] for all.

Those who work and spend everything would be contributing to their own care later.

Of course this doesn't solve the main problem of 'migrants' who contribute nothing but want everything. Look at the NHS

Feel free to critisize!

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David Harvey

Jul 17, 2012 at 13:41

I think you have a good point John Brace the problem might be that many of the people make so little they pay no tax or, in fact are unemployed. We are creating millions to add to that list daily in the rush to make poverty buy us out of trouble. These make up a large proportion of the none savers etc. I have said many times and believe that the poverty being created now will come back and bite us later.

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