Social Care Reform in Great Britain

Older people campaigning

There have been numerous attempts in Great Britain to establish a framework for the funding and provision of social care services since the 1990’s. The Royal Commission on Long Term Care 1999; the Wanless Review in 2002; and Shaping the Future of Care Together (2009) have all suggested reforms in the area of social care.

The Coalition Government published its long awaited White Paper and Draft Social Care Bill to reform the care and support system in GB on 11 July 2012.

The Coalition Government is proposing major reform of the social care system in England and Wales. This reform builds on the recommendations from the Law Commission’s review of adult social care legislation and the Dilnot Commission’s recommendations on funding long-term care and support, as well as the Department of Health’s consultation on a vision and outcomes framework for adult social care.

The key points are:

  • Long term funding reform: The principle of the approach of the Dilnot Commission of capping lifetime contributions and an increase in the means test has been accepted. However, there are no clear commitments on implementation of these funding proposals.
  • The Law Commissions Review of Adult Social Care Law: The draft Care and Support Bill retains and clarifies most of the current rights of older and disabled people and adds important new legislation, including rights to services for carers and legislation to safeguard adults at risk of abuse.
  • A new eligibility criteria and a national eligibility threshold: These will be developed alongside a new assessment system and will replace the Fair Access to Care Services.
  • Measures to improve information and advice: A commitment to develop a single national online portal and further developing local authority websites.
  • Prevention practice and early intervention: Local Authorities will have a new duty to incorporate prevention and early intervention into care commissioning and planning.
  • Increased legal rights for carers: This will apply to both assessment and services, and strengthen their entitlements to support.
  • Personalised Services: This will be the underlying principle for the provision of care services through entitlement to personal budgets or the right to request a direct payment.
  • Other key points: Improved access to aids; enhance co-ordination and integration by local authorities and national minimum standards for workforce training.

Age UK warmly welcomed the policy proposals in the White Paper and the legal reforms as they recognise that these have the potential to significantly improve the quality of care available and help create a care system that is fairer and more straightforward for older people and their families. However, they have outlined their concerns that these reforms cannot be fully realised until the funding issue is resolved, 

“More than a year on from the publication of the Dilnot Commission’s report, we are left asking just how strong the Government’s commitment is to implementing his two key recommendations: to raise the means-test threshold and to set a cap on costs.” (Age UK, 11th July 2012)

Impact on Northern Ireland

Although these proposals relate to England and Wales only, there is potential for these proposals to influence and impact directly on older people and their families.

In the first instance, any changes to increasing the means test threshold for entitlement to care will be directly relevant in Northern Ireland. The means test is currently set at £23,250 for institutional based care across the UK. The Dilnot Commission proposed changing this to £100,000.

In addition, changes to capping the costs of care over one’s lifetime (£35,000 as suggested by Dilnot) and proposed changes for those who reach adulthood with a care and support need and those who acquire a care and support need throughout their adult life may leave disabled and older people at a serious disadvantage in Northern Ireland.

Next page:
Social Care Reform and the Impact on Older People

Age NI Advice Line:
0808 808 7575

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