Government admits ‘five-year delay’ on National Care Service

The Government’s social care plans were branded a “train crash” today after Health Secretary Andy Burnham confirmed a National Care Service would not be created for at least five years.

An NHS-style universal service was put at the heart of a long-awaited White Paper described by Prime Minister Gordon Brown as a “bold and ambitious” reform of services for the elderly.

But the paper confirmed it would not be operational until “after 2015” while a cross-party National Care Commission examines options for how people would contribute.

Among them will be a so-called “death tax” of 10% on estates which Mr Burnham indicated remained on the table despite being apparently ruled out by Chancellor Alistair Darling last night.

Opposition parties accused the Government of dodging the need for urgent action amid ongoing political arguments over how long-term care will be funded.

The White Paper commits the Government to creating a “comprehensive” service “based in need rather than the ability to pay”.

“The commission will determine the fairest and most sustainable way for people to contribute. It will make recommendations to ministers which, if accepted, will be implemented alongside the introduction of a comprehensive national care service in the Parliament after next,” it said.

It also contains a commitment to making residential care free after the second year by 2014 on top of legislation being debated at present to exempt the most needy from charges.

In the foreword to the document, the Prime Minister wrote: “This is a new chapter in the story of our welfare state: a chance to change the way care and support are delivered.”

The Tories, who propose a voluntary £8,000 one-off premium at 65 to guarantee free care, ridiculed the blueprint.

“The Government is in complete retreat and they have ended up with not a White Paper but frankly a train crash,” shadow health secretary Andrew Lansley said.

“We seem to have arrived at the point where Andy Burnham is saying he wants everyone to have free care but he doesn’t know how to pay for it.”

Liberal Democrat health spokesman Norman Lamb said: “After 13 years in power spent ducking social care reform, we probably shouldn’t be surprised that Labour has once again hit it into the long grass.

“A White Paper without any commitment to substantial change in the next Parliament is barely worth the paper it is written on.

“We’re now being offered a series of piecemeal reforms that have not been properly thought through or costed.

“Seeking consensus is the right approach but that will only work if the cross-party commission is free to consider all ways of funding social care, not just Labour’s preferred policy.

“The commission should report within a year so changes can be implemented straight away.”

Care Quality Commission chair Dame Jo Williams said: “The White Paper is an important step in beginning to address the need for a fairer and more consistent approach to meeting people’s care needs.

“We welcome the emphasis that it places on personalised services and the importance of listening to service users and their families. We have been arguing for clear national standards for people’s entitlements to care, no matter where they live, and that their assessments of needs should be portable if they move.

“In our State of Care report in February we called for a fundamental culture shift in health and social care to achieve joined-up services and give people more choice and control and support their independence.”

Michelle Mitchell, charity director for Age Concern and Help the Aged, said: “This is a very important day for securing decent care in later life.

“We welcome the Government’s staged approach to reforming the care system, its commitment to give free care to those most in need and free care to those in residential settings after two years.

“These reforms comprise a significant reform agenda for the next Parliament. The idea of a National Care Service sounds fantastic. Almost everyone can agree with the principle of a new system that guarantees more flexible support, earlier help and clear national entitlements rather than a postcode lottery of unmet needs.

“But if it isn’t adequately funded, the vision of a new national care service cannot be delivered and will ultimately fail the most vulnerable people in our communities.

“Ministers must say how much it will all cost and how they plan to plug the immediate £1.75 billion black hole in social care funding expected to open up within the next two years. By the end of the next Parliament, we’ll also need billions more to fund the growing need for social care, implement the new national entitlement and fund the free care at home proposal.

“Now that the White Paper is published, older people and their families will be looking to see what reforms the other political parties can offer to fix our broken care and support system.

“Our recent survey shows that care is shooting up as one of the top priorities for all age groups in the coming election, not just those already in later life. So politicians must set out their plans for care reform in full to give voters a choice.”

Mr Burnham said: “All options would be within scope when (the commission) make their deliberations, although we will not introduce any change within the next Parliament.”

The proposals from the commission will be put to voters at a general election before being enacted, he stressed.

Mr Burnham suggested that critics were not “respecting” the scale of the changes.

“But the fact is that this is a big reform that is complicated,” he added.

The cost of the NCS is expected to be £3 billion in its first year of operation, in today’s money, Mr Burnham said.

Care Quality Commission chair Dame Jo Williams said: “The White Paper is an important step in beginning to address the need for a fairer and more consistent approach to meeting people’s care needs.

“We welcome the emphasis that it places on personalised services and the importance of listening to service users and their families. We have been arguing for clear national standards for people’s entitlements to care, no matter where they live, and that their assessments of needs should be portable if they move.

“In our State of Care report in February we called for a fundamental culture shift in health and social care to achieve joined-up services and give people more choice and control and support their independence.”

Michelle Mitchell, charity director for Age Concern and Help the Aged, said: “This is a very important day for securing decent care in later life.

“We welcome the Government’s staged approach to reforming the care system, its commitment to give free care to those most in need and free care to those in residential settings after two years.

“These reforms comprise a significant reform agenda for the next Parliament. The idea of a National Care Service sounds fantastic. Almost everyone can agree with the principle of a new system that guarantees more flexible support, earlier help and clear national entitlements rather than a postcode lottery of unmet needs.

“But if it isn’t adequately funded, the vision of a new national care service cannot be delivered and will ultimately fail the most vulnerable people in our communities.

“Ministers must say how much it will all cost and how they plan to plug the immediate £1.75 billion black hole in social care funding expected to open up within the next two years. By the end of the next Parliament, we’ll also need billions more to fund the growing need for social care, implement the new national entitlement and fund the free care at home proposal.

“Now that the White Paper is published, older people and their families will be looking to see what reforms the other political parties can offer to fix our broken care and support system.

“Our recent survey shows that care is shooting up as one of the top priorities for all age groups in the coming election, not just those already in later life. So politicians must set out their plans for care reform in full to give voters a choice.”

Carers UK welcomed the “bold plans” but joined calls for the commission to decide on funding options more quickly.

Chief executive Imelda Redmond said: “We warmly welcome these bold plans for a National Care Service of the kind that older and disabled people, their families and carers have been calling for.

“These proposals promise to end the social care postcode lottery and protect families from the crippling costs of care which they currently see draining their savings and putting at risk family homes.”

She said a cross-party commission was the best way to overcome “political point-scoring on these issues”.

But she added: “Although the vision is clear and ambitious, the White Paper in itself does not contain enough detail on the question of funding.

“The promised commission on funding must be brought forward as a matter of urgency, to deliver on the specifics, and give families confidence that the sort of care system they need will become a reality.”

Lord Lipsey, the Labour peer who led opposition to the proposed National Care Service in the House of Lords, said the latest proposals did not make sense.

“This system proposed by the Government today is unfair because it is going to mean the poor paying money, but the benefits going to the better off,” he told BBC Radio 4’s The World At One.

“It is unaffordable, even more expensive than the proposal that I was attacking in the House of Lords, and, worst of all, it doesn’t provide the better services that elderly people and their carers really need.”

More pressure for an earlier decision came from the National Pensioners Convention (NPC) and mental health charity Mencap.

NPC general secretary Dot Gibson said the care service would be a “tremendous step” but said 2016 would be too late for many older people and carers.

“Social care in Britain has been in crisis for decades, but many older people and their families will not be able to wait until 2016 before they get any help,” she said.

“We must do more and faster to give financial help to the army of carers, improve the regulation and standards of care provided and ensure care staff are properly trained and paid for looking after our loved ones.”

She urged all parties to accept the need to fund the service through general taxation and to include older people’s representatives on the commission deciding funding.

David Congdon, Mencap’s head of campaigns and policy, said: “We are concerned that at this stage there is still no sustainable, long-term funding plan for social care – even after two consultations. A funding plan needs to be decided as a matter of urgency.”

He also called for representation on the commission for disabled adults of a working age – warning that the debate had been dominated by the needs of the elderly.

“These adults’ needs have been sidelined as a result of the recent focus on the older generation during the political debate,” he said.

Shadow health secretary Andrew Lansley said: “The death tax is alive and kicking – despite their attempts to bury it in the small print of policy in the hope people won’t notice.

“The simple fact remains that if Labour win the election, they’d introduce plans for a death tax to pay for care.

“Once again, when Gordon Brown sees a problem, his reaction is to place a new tax on working people.

“Labour have had 13 years to sort this issue out. Their failure has caused misery for thousands of families.

“These proposals will do little to alleviate that suffering, thousands of people will still have to sell their family home to fund their care.”