Watch on… Long term care funding

White Paper – Building The National Care Service

With the publication of the White Paper on March 30th, the present Government committed itself in the next Parliament to “create a National Care Service that is universal and fair” for “all adults in England with an eligible care need”.

The ultimate commitment is to the development of “a National Care Service in which everyone is protected against the costs of care and in which no-one needs to lose their home or their savings to meet those costs”. The proposed key stages are:

  • free personal care at home for those with the highest needs by 2011,
  • entitlement to free care (apart from accommodation costs) for all people in residential care for more than 2 years by 2014, and
  • the full establishment of a “comprehensive National Care Service” -including a funding system based on universal contributions, and the establishment of “nationally consistent eligibility criteria enshrined in law” – from 2015.

The National Care Service, which will be led by local authorities, will mirror and work in close partnership with the National Health Service – with the introduction of a new duty on all NHS bodies and local authorities to work together to deliver integrated adult care services, and the development of a quality framework to complement the NHS quality framework.

The White Paper rules out any changes to Disability Living Allowance (DLA) or Attendance Allowance (AA) – at least in the next Parliament – but commits to the realisation of £4bn p.a. efficiency savings within the current health and social care system.

In response to the majority preference expressed in the 2009 Green Paper consultation, the National Care Service is to be based on a Comprehensive funding system – a guarantee of free care when required in return for a compulsory contribution. A Commission will be established to consider the details of payment and options available.


There is a general election due in May, with the significant possibility of a hung parliament.

At present the three main parties remain split three ways over the three main funding options – with the conservatives adamantly opposed to what they describe as a ‘death tax’ option.

The details of  the proposed universal funding and eligibility systems – as well as the realisability of the proposed £4bn efficiency savings – remain to be determined.

It is unlikely that the principle of extending the availability of care at home will “save money compared with expensive residential care” [White Paper Foreword]. According to Planning4care estimates, the average cost of supporting older people with the highest needs in their own homes is calculated at around £500 per week – the same as for residential care.

The ‘watch on’ continues!

Click here to view the White Paper; ”Building The National Care Service”

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