Threadbare social care white paper plans exposed by MPs

The holes that exist in the new care and support white paper extend way past a lack of decision on funding

Without any decision on funding reform, the social care white paper for England was always going to have a gaping hole at its heart. But MPs have now exposed how threadbare the blueprint is in other important respects.

Three central planks of the white paper, heavily spun by ministers in the absence of any funding decision, buckled alarmingly under more than two hours of questioning of health secretary Andrew Lansley by the Commons health select committee.

First, the so-called ban on home care visits as short as 15 minutes for older and disabled people. How exactly would that work? Well, said Lansley, we’re thinking about that now, but it would be a case of “spreading best practice” on commissioning of care in association with the Local Government Association and the Association of Directors of Adult Social Services.

So not actually a ban, then? No, said Shaun Gallagher, director of social care at the Department of Health, coming to the minister’s aid. “It’s not simply about how long is right for a visit. There might be cases where a short visit is exactly what is needed.”

Second, the national eligibility threshold for care and support. This had been presented as setting a minimum level of help across the country and an end to the postcode lottery. What work had been done on modelling it and what was it likely to cost?

It would, said Lansley, have “quite a modest” cost – £12.2m a year had been estimated – because it was envisaged that the threshold would be set at the level of “substantial” needs that was already observed by most councils under the existing, locally based system. Variation had reduced considerably in the past two years, and few authorities now set any other bar.

Did that estimate include the cost of meeting any unmet need, asked Stephen Dorrell, the chair of the Commons committee, because this had been identified as a major problem? No, said Gallagher, the department had no figures for that.

Third, the universal deferred payment scheme, enabling people to avoid having to sell their home to pay for their care until after their death. This, intended to take effect in 2015, would involve councils offering families loans repayable with interest to cover the cost of the scheme.

Was it not the case, asked Labour MP Barbara Keeley, that there was already a scheme that worked well, whereby councils offered loans without interest? Could Lansley identify any case where such a loan request had been refused?

Well, intervened Gallagher, the existing scheme was “patchy round the country”. One of the reasons for that was that councils had to meet its cost. He would prepare a written answer on the extent of its availability, but that would be based on independent surveys and research because the department did not monitor it.

It is true, as Lansley told the committee, that the white paper has been broadly welcomed for what it is. Setting aside the widespread disappointment that decisions have been deferred on funding reform, there is enthusiasm for many of its proposals and the planned general updating of social care law.

But to try to compensate for the lack of an answer on funding, ministers have plainly oversold some of the measures. And, as the select committee’s probing revealed, that risks undermining much of what is good in the wider package.