What are the proposals for the future of Attendance Allowance and Care Funding?

 David Kidney, MP for Stafford is concerned that some vulnerable people may be made anxious by the current talk about the future of Attendance allowance. He says “Sometime news stories arise and it is not clear where they have come from. It is likely that the current scare about the possible future of attendance allowance is a result of misunderstanding about the complex changes that are needed to make our health and care systems able to cope with our ageing population. I would like to reassure people that changes that are being made to the way care is funded are not about cutting benefits, they are about giving us the care system we need for the future.”

The background to the proposed changes is that the demographic structure of Britain will change radically over the next 30 years. People are living much longer, and surviving often in seriously bad health for the last years of their life. The birth rate is also falling, which means that the way we have done things in the past, where our children pay for our old age through the taxes they pay is simply not an option. They will not be able to afford to do this.

We all know that the care system is already under great pressure, and this pressure will inevitably keep growing.

The Governments of the last 30 years could with justice be criticised for not making the radical changes to the care system that have been needed. The last Conservative government experimented with shifting a lot of care out of hospitals and into to private care homes and care companies. They trusted that there would be a market led solution and that private insurance systems would emerge to help people cover the costs of this change. The systems that did emerge were not strong enough, people did not buy into them and they failed.

This Government has made a series of amendments to the way in which the care system has been funded. It has made sure that that health element of care is covered, and it has gone further than that to bring in the continuing care system, but it was clear that this was still pretty unfair to people with dementia or other debilitating illnesses, and that none of the changes were radical enough.

It is because the government recognised that we needed a comprehensive approach to how we provide care – something that covers all needs from the helping hand at the beginning of illness through to end of life care, that it was decided that we had to look at the entire system from top to bottom. That is why there has been a very detailed consultation process which has gone on for over two years to ask organisations and individuals to give us their views on how we should go about providing care.  

Here are some of the things that people told us that they want.

·         Help should be there at the early stages of health problems to prevent people losing independence and to help them get back on their feet after periods of illness.

·         Emphasis should be on keeping people in their own homes for as long as possible.

·         There should be a common framework for care funding so that people can expect the same level of service and charges wherever they live in England.

·         There should be an effective and fair way of spreading the risk of care costs so that people who are unlucky enough to have a prolonged illness should not have to lose their life savings to pay for it.

We found that there was a lot of discussion throughout the consultation about Attendance Allowance, and it was clear that this was a very popular benefit for the following reasons:

·         It is needs based rather than means tested,

·         It is suitable for helping people who are capable of living with a degree of independence so long as they receive suitable help.  

·         It is available throughout the country so that people can if needs be move to be near relatives with the certainty that they will take the attendance allowance with them.

·         People are free to spend it in the way that they choose, and can make flexible arrangements to suit themselves.

But there are limitations. Attendance allowance does not go far enough. It is a really useful benefit, but when people’s needs become more complex it is not enough to allow people to remain independent.

The new Personal Care at Home Bill, announced by Gordon Brown this autumn is intended merely as a stepping stone towards the full National Care Service. It provides a temporary fix for this, by making much more funding available to keep people who have very high care needs at home where they will have the support of their family.

The Conservatives are also trying to find an approach to the problem of high care costs. They have made a very different proposal. They are looking for people to make a voluntary contribution of £8,000 at retirement in order to cover them against the risks of having to go into a home. This is something that does not go far enough. It is addressing one of the problems that exist within the care service, but it is not seeing the whole picture. They have already seen that there are problems with these proposals. They recognise that it would not be fair to expect the insurance industry to pay out the very high costs of luxury care homes, and so they would immediately be into the problem of having to cap payments under the scheme. It must also be said that their voluntary insurance based approach to this did not work when it was set up in the 1990s and there is no reason to suppose that it would do any better now. 

What the government wishes to do, is to bring in a bill which will give us a fair way of funding a National Care Service. Something that would be needs based, and free at the point of use in the same way as our health service. There are several options for doing this. We will not know which one people have opted for until the scrutiny of responses to the green paper has been completed. Perhaps the best option is a comprehensive system which spreads the risks of care costs as widely as possible.

The opposition, who have opted to have an opposition day debate on Disability benefits (see here) have perhaps not fully understood what is being proposed. They have however identified that people are afraid they might have their Attendance Allowance taken away. I would like quickly to reassure people that there is no need for this fear. There is a guarantee that anyone who receives either Attendance Allowance or Disability Living Allowance will not lose out, and for new claimants the National Care Service will effectively keep all the best aspects of Attendance Allowance, but it will give us something which goes much further in allowing people to remain independent for as long as possible, and to cover care costs in residential care if that should be needed.

Editors notes.

David Kidney has been one of the MPs most active in driving forward reforms of the care of the elderly. The following pages indicate some of the detailed background work he has been doing in Stafford and at Westminster on this matter.

http://iwc2.labouronline.org/168433/background_material_on_care_funding

http://iwc2.labouronline.org/168433/introduction_to_care?PublishKey=22b63659-5678-66d4-21d5-a917c3805d51

http://iwc2.labouronline.org/168433/churches-together---and-caring-for-an-ageing-society-

http://iwc2.labouronline.org/168433/free-personal-care-under-a-labour-government

http://iwc2.labouronline.org/168433/counting-the-cost--alzheimers-society-report-on-hospital-care-an

http://iwc2.labouronline.org/168433/welfare-state-mark-ii-