Rethink plans for the funding of long-term care for the elderly, says the Bow Group

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Friday, September 11, 2015
Dr Jonathan Stanley

The Bow Group today calls on the Government to rethink its plans for the funding of long-term care for the elderly, focusing funding on those with the greatest need.

The author, Dr Jonathan Stanley, an NHS medical doctor, demonstrates how the Government’s current plans to raise the current cap on costs do nothing to prevent costs of nursing for the elderly spiralling catastrophically out of control, and protect no one but a small number of asset rich people.

Dr Stanley has recommended scrapping the financial cap altogether, replacing it with a time limit of five years on payment liability.


Dr Jonathan Stanley said:

“We need to see the cap scrapped, it is too high to meet its original goal and does nothing to protect those for whom care costs are highest: those living longest and those with high care needs.

"It’s an accountant’s nightmare and does little to promote a competitive insurance market for care costs.  Capping the costs after five years in care, and bringing in full NHS nursing into care homes will better serve those in greatest need.

“There is a valley of despair that every nurse has seen, patients trapped in hospital while relatives search for a new nursing home and wait weeks for inpatient assessments.

“We have made huge strides in finding a sustainable method of funding long term care but the cap proposed is in the wrong place and serves the wrong people…A co-payment system based on the capital rules drawn by Sir Andrew Dilnot can be made to work if the cap is placed on the level of care and length of stay one has to part fund, just as an insurance policy contains an excess payable by the claimant.

“A small increase in initial payments by many will preload the system to insure the few who require care for greater than 5 years.  Given the huge gains in house prices over recent years it is right care costs are funded more from capital draw down and not general taxation.”

Ben Harris-Quinney, Bow Group Chairman, says

"The post war baby boom generation entering old age is going to place huge pressure in the NHS which, if handled incorrectly, will threaten it's very existence.

It is clear that it will not be financially sustainable to offer comprehensive personal care to all those in need as has been the case in the past, and some very difficult decisions are therefore required at government level.

The government's cap on care costs is an attempt to address the problem, but our research suggests it's going to leave more people exposed to crippling costs than if the cap came in after 5 years of care.

We feel this would offer a better level of care, whilst still offering a sustainable economic solution to the strain of the baby boomers."

Peter Smith, Bow Group Research Secretary, says

“This is a very serious matter which scares the life out of local authorities and families across the country. Care of the elderly will be one of the largest social problems the First World faces over the next decades.

Jon Stanley’s paper is to be welcomed because it goes against the grain of limiting personal financing of elderly care to what politicians believe is electorally acceptable.”

Recommendations from the paper:

  1. The cap on care costs is a deeply flawed concept and should be scrapped, not least as it doesn’t include living costs, so it is not a true reflection of the cost of long-term care. Instead, the cost of care will be transferred to the taxpayer after five years, removing the threat of catastrophic care costs from the elderly.
  2. Asset depreciation to be slightly raised during the first three years of care by 20%.
  3. Scrapping cash payments for nursing care in homes, bridging the valley of despair between hospitals, nursing care and residential care. Funded care should include up to 16 hours of care assistant time per week, the average number of care assistant hours per week in a residential home. This will protect people who need above average hours of care from catastrophic costs.