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Editor's blog Tuesday 13 July 2009: The £12,000 lottery ticket for social care; and the open-closedness of government | Health Policy Insight
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Editor's blog Tuesday 13 July 2009: The £12,000 lottery ticket for social care; and the open-closedness of government

Publish Date/Time: 
07/14/2009 - 10:34

Good morning. The green paper on funding social care provision should be out shortly. What has been trailed in the press is that a figure of £12,000 per person will be proposed as an insurance payment against requiring full-time social care in old age, which will replace the current asset threshold of £23,500 before social care can be provided free (not to mention the eligibility criteria threshold lottery, which makes postcode prescribing look like a minor squabble).

The £12,000 may be paid up-front in lump; in stages; or deducted from any estate remaining after death.

It has been clear for some time that the funding of social care requires proper and costly consideration. The Kings Fund has been campaining consistently and creditably for some time on the issue. (Speaking of whom, HSJ's Sally Gainsbury reveals that their chief executive Niall Dixon is off to run the GMC, just as they become responsible for revalidation and CPD of doctors. Niall likes a quiet life ...)

The BBC News Online report suggests that although there are currently a 4:1 ration of taxpayers to over-85-year olds, the figure will drop to 2:1 within 40 years, and "threatens to create a £6bn black hole in finances over the next 20 years".

Just at the moment, speaking personally as a self-employed 38-year-old, the idea of needing to find £12,000 to insure myself against a possible social care need in old age is not wildly attractive.

That said, something has got to be done. The magical money tree that grows cash for free has not yet been discovered; and I am willing to bet that it will not be discovered in my lifetime (unless I turn myself into a major bank that becomes too big to be allowed to fail).

Much will depend on what is to be done with the money (i.e. does it go into a real actuarial insurance pool, and not into HM Treasury's coffers?); and on the genuine and legally-enshrined abolition of means-testing for those with social care needs to claim. Because let us be quite clear, without these things, this policy is a crock of the brown stuff.

If it is an insurance, then it has to be separate from a tax. It has to trigger an entitlement; it has to be independently legally regulated. It has not not disappear into the murk of unhypothecated government spending.

If it is simply a new tax to meet a clear need, then that is fine-ish (unless we run into the public sector pensions problem of paying out of income in-year and not having a real fund) - but under no circumstances will it be legitimate for anybody to pretend that it is an insurance. It won't be.

It will be a new tax, plain and simple, which will not trigger an entitlement; it will allow eligibility criteria to be raised and lowered according to prevailing economic conditions and prevailing political expediency and orthodoxy.

Raising taxes is a legitimate economic and political decision. It is coming very soon to a Budget near you. It is potentially efficient and equitable in progressive terms. Let's see what actually emerges.

Update 4.28 pm - phew! Twenty thousand pounds. But three options. Mmmmm. What happens to those who can't pay out of their estate?

Open-and-closed government
You will remember the 9/11 fuss over Blairite transport minister Stephen Byers and his fantastic Special Adviser Jo "very good day to get out anything we want to bury" Moore. Martin Sixsmith, the ex-BBC journalist who was the civil servant in question has finally got the government to release the details about how he was smeared in the subsequent media melee Times.

Guess who (you have to scroll down 4/5 of the way for the answer, because it certainly wasn't Simon Stevens) circulated false information about Martin Sixsmith? This is, of course, unless Sixsmith is lying and thus libelling Ali C - in which case, no doubt, a writ will be forthcoming.