More than 18 months after Andrew Dilnot’s landmark report into social care was published, the coalition will finally unveil its planned reforms today. In a statement to the Commons, Jeremy Hunt will announce that the government will introduce a cap of £75,000 on care costs and increase the threshold for means-tested support from £23,250 to £123,000, so that no one with assets worth less than this amount is forced to pay. The £1bn-a-year cost of the plan will be met through higher national insurance contributions on employers and a six-year freeze in the inheritance tax threshold at £325,000 (George Osborne’s famous 2007 pledge to increase it to £1m now being a distant memory of a pre-austerity age).
The first point to note about the £75,000 cap is that under the coalition’s timetable it won’t actually be introduced until April 2017. Thus, as shadow care minister Liz Kendall has noted, it “won’t do anything for the hundreds of thousands of elderly and disabled people who are facing a desperate daily struggle to get the care and support they need right now”.
In addition, the cap, which excludes food and accommodation costs (typically around £7,000-£10,000 a year), is set a significantly higher level than that recommended by Dilnot. His report called for a cap of between £25,000 and £50,000 (settling on a figure of £35,000) and warned that anything outside of this range “would not meet our criteria of fairness or sustainability”. A cap above £50,000 “could mean people with lower incomes and lower wealth would not receive adequate protection.” Even if we adjust the £75,000 cap for inflation (it is based on 2017 price levels), that still leaves it at £61,000 – £11,000 higher than Dilnot’s recommended maximum.
Interviewed on the Today programme this morning, Dilnot said that he regretted the coalition’s decision to opt for a £75,000 cap but recognised that “the public finances are in a pretty tricky state”. By capping costs for the first time, the plan would still “radically reduce anxiety”, he argued. But others have been less generous.
Labour has pointed out that since it will take the average person around four years before they reach the cap, it will not benefit the majority of patients, most of whom don’t make it this far. Dot Gibson, the general secretary of the National Pensioners Convention, estimates that the proposals will help “just 10 per cent of those needing care”. Labour is currently developing its own social care plan as part of its policy review but is likely to recommend a cap no greater than £50,000.
The government’s hope is that a cap of £75,000 will encourage insurers to offer policies to cover costs below this amount. As Hunt said on The Andrew Marr Show yesterday, “We don’t want anyone to pay anything at all. By setting an upper limit to how much people have to pay, then it makes it possible for insurance companies to offer policies for people to have options on their pensions so that anything you pay under the cap is covered.”
But Labour is highlighting the fact that Nick Starling, the director of general insurance and health at the Association of British Insurers, has previously dismissed this as wishful thinking. He told the health select committee in November 2011: “I do not think there will be pre-funded products. That is unlikely. I speak on behalf of the insurance industry, but I bring independence in the sense that, except for the immediate needs annuities which [Chris] Mr Horlick [of Care Partnership Assurance] provides, there are no products out there. I am not grinding a particular axe about particular forms of products. I am saying that, in a sense, we have a chance to think in quite an open way, unencumbered by a whole forest of products already out there. In that sense, the thinking we have been doing on this is independent.”
A cap on costs is, as Dilnot suggested, better than no cap at all. But unless Hunt springs a surprise on MPs today, it is already clear that this will not be a lasting solution to the care problem. For that, one suspects, we will have to wait for a change of government.
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