Independent Age, the older people’s charity, is calling for free personal care for all those who need it in England, who are aged 65 and over, to help solve the social care crisis. In new polling carried out by YouGov exclusively for Independent Age, the majority of adults in England would support paying more in tax or a lump sum to fund free personal care.
Why free personal care?
Free personal care for all would mean providing for free the support a person receives for everyday activities, including things such as getting in and out of bed, getting dressed, preparing a meal or shopping. This type of care can be provided at home or in a care home, but does not include costs such as food, utilities or other expenses.
Free personal care for all would simplify the system, making it easier for people to know exactly how much they’d need to pay while receiving care, and what they’d get in return, as well as making it quicker to transfer patients out of hospital. It would also mean that no-one would have to sell their home in order to pay for care. Furthermore, the cost of introducing free personal care is only slightly more than the government’s proposals to deliver social care reforms.
Public support for free personal care
According to the YouGov poll of more than 2000 English working-age adults (from a GB-wide sample), almost three-quarters (74%) of adults in England support free personal care for everyone who needs it, with more than two-thirds of adults in England (69%) agreeing that they would be willing to pay more tax to provide free personal care for all, either through a small increase in Income Tax (27%), a small increase in National Insurance (25%), a new small tax for people aged between 40 and retirement age (11%) or paying a lump sum on retirement (6%). This overwhelming support is consistent across political leanings, gender, age and region.
Possible social care funding options: A Taxing Question
Independent Age has released a new report, A Taxing Question: How to pay for free personal care, produced in conjunction with Grant Thornton UK LLP and The Social Market Foundation, which looks at various funding options for social care, including what they would cost the individual and what the funding situation might look like in 10 years’ time.
Some of the most viable options include increasing Income Tax and increasing National Insurance, the two options which had the most support in the public poll. Other options that would be viable include asking everyone between the ages of 40 and retirement age, and their employers, to pay a new small tax; or asking those who can afford it to pay a lump sum of £30,000 on retirement.
Looking at increasing all rates of Income Tax as an example, this would:
- Generate an extra £6.10 billion in 2020/21 if raised by just 1%
- Be able to provide free personal care for all in 2020/21 if raised by 1.09%
- Be able to provide free personal care for all in 2030/31 if raised by 2.11%
- Cost an individual earning the national average annual salary of £26,832 around an extra £12.47 a month if their Income Tax contribution was increased by 1%, which would equate to approximately £7,033 over 47 years (assuming their salary remained the same from 18 to 65)
However, according to the report, there are no easy answers, with no single funding option delivering the level of reform that the public want and older people need in ten years’ time. Some funding options, including increasing business rates or Corporation Tax, increasing Council Tax or Inheritance Tax, or charging National Insurance for the over 65s, fall far short of addressing the social care funding gap.
The report looks at how the proposed funding mechanisms would achieve both the Government’s proposed “cap and floor” model and free personal care, concluding that ultimately the difference between the costs would be relatively small in government terms – around £1 billion in 2020/21, rising to £2 billion in 2030/31 - but that free personal care would result in significant benefits for all older people. A policy of free personal care for all would also send a clear message about how we, as a country, value older people.
Social care and NHS integration
Free personal care at home for people aged 65 and over is currently available in Scotland, which shows that it is possible. It has helped to integrate the care system with the NHS because setting up care packages is less complicated, and does not need to include discussions about income. Overall NHS costs have decreased in Scotland, delayed transfers of care have decreased, and more people are receiving care at home, allowing them to retain their independence.
A social care system that is not means-tested puts it on the same level as the NHS, and provides a more equal service for those who need it. The A Taxing Question report has tried to address some of the issues of the still underfunded Scottish model and offer solutions for sustainable, long-term funding.
Janet Morrison, Chief Executive of Independent Age, says, “Many older people are being let down by a social care system in crisis that is failing to meet their needs. Giving older people the right to free personal care would change that. Not only is it what people want, but they are also willing to pay a bit more tax to get it. It is simple and costs a similar amount to the government’s preferred proposals. However, the government also needs to ensure people are getting the support they need, or the public will not tolerate contributing more in tax or other means to pay for social care.
“In addition, free personal care would significantly reduce the number of older people marooned in hospital due to lack of available personal care, support the joining-up of health and social care support and ultimately enable many more older people to live independently and stay in their own homes for longer.”
The government needs to be aware that, if people are being asked to pay more, they need to be reassured that the system is better than it was, and has addressed previous failings, so that it meets the needs and expectations of older people in terms of both availability and quality.
Alex Khaldi, Partner and Head of Social Care Insights, Grant Thornton UK LLP, comments, “With public sector finances edging ever closer to a tipping point, this report marks an important contribution to the ongoing debate around the future of social care funding. Presenting the financial output of each funding option, along with the tax implications, provides a detailed picture of what should be seriously considered going forward.
“Time is running out to address the funding question surrounding the future of our struggling social care system, and it is vitally important that taxation is brought into the discussion to ensure we create a funding system that is fair for everyone. While we know there is no one easy option, this report makes it clear that many people are not adverse to the idea of increased taxation, as long as it is used as intended.
“We hope this analysis forms a useful part of the public debate to help address the growing gap between the increasing demands of a changing demographic and the funding of the system designed to support them.”
Independent Age is urging the government to introduce a social care contribution aligned to a commitment to provide free personal care, in order to help improve social care for older people, now and in the future. This will not only make it easier for people to navigate the system, but will also reduce NHS spending, make transfers of care from hospital faster, and will allow more people to live at home independently for longer.
In addition to this, in the short term, the government should allocate immediate funding to ensure the funding gap does not increase as a minimum. In the long-term, there needs to be a commitment within the NHS 10-year plan, and social care reforms, to radically reform public health and preventative care, to enhance older people’s independence.