Whilst the social care debate on funding has once again been raised by Paul Burstow and Centre Forum, calling for the implementation of the Dilnot proposals with funding from means tested winter fuel allowances the fact remains that this is only one side of the debate and, arguably, unanswerable without tackling how much social care actually costs and who is eligible for funded social care.
One issue largely glossed over is who will be eligible for social care services and state funding under any new scheme.
Over the last few years those entitled to funded support have been needing to meet ever tightening criteria meaning many thousands have not been entitled to support even when they have high (but not critical) needs. This naturally has led to a fall in the numbers of older people receiving supported care services and increased the numbers either paying for themselves or relying on family and friends for support in everyday life.
The debate on the Dilnot proposals must include the level of need at which people are entitled to state support. For those not quite meeting the criteria but with little other option may well still need to sell their homes in order to pay for necessary care services and it is essential that this element of the proposals is equally publicised before many thousands are led into a false sense of security believing that their care needs will be met by the state after the cap.
Local Authorities have, over recent years, continued the practice of increasing fees to providers at less than the rate of inflation and over the last two years many have given no increases at all. The shortfall is often made up by care service providers by charging top up payments which individuals pay themselves or by the level of fees they charge private paying users.
While the Dilnot proposals state that no one should pay more than £50000 for their care costs it does not mention the level of fees in the equation. So once an individual has reached that cap will the Government/Local Authorities pay the higher rate normally charged by providers or will they only pay the reduced fee associated with the current system.
Additionally Dilnot proposed a rise in the means testing threshold to £100,000 if introduced this will immediately move many of those who currently pay private fees to being on local authority fees, dramatically reducing the income of care service providers
If there is a dramatically big drop in what providers are receiving then how will care providers survive with radically reduced income and what impact will that have on the quality of care services.
Of course that debate is somewhat mitigated by the fact that the Dilnot proposed cap only applies to care services not to accommodation or food. On this issue the recommendation is that individuals be charged between £7000 & £10000 a year to cover such costs.
The debate needs to be wider than the proposed cap and include exactly who will be eligible, how the cap will impact on the quality of care provision and the impact it will have on the lives of those not eligible for state funded care services.