In Depth

Should elderly care be free?

Think tank says taxpayer-funded social care for over-65s would save NHS billions every year

Providing the elderly with free care would save the NHS around £4.5bn a year by 2030, according to a new report by a leading research group.

The Institute for Public Policy Research (IPPR), a centre-left think tank, says that giving older people in England free help with cleaning and eating would improve their health and cut the demand for hospital treatment. 

The proposal “highlights the growing political consensus that personal care should become free for over-65s”, bringing England into line with Scotland, where such care has been free since 2002, The Guardian reports.

Harry Quilter-Pinner, senior research fellow and lead report author at IPPR, argues that funding elderly care would also help redress the balance in an unfair system, says Sky News.

“If you develop cancer in England, you are cared for by the NHS, free at the point of need for as long as it takes,” he said. “But if you develop dementia, you’re likely to have to pay for all your own social care - running up potentially catastrophic costs in the last years of your life.”

The IPPR say that the new system could be funding by an income tax rise of 2%.

Such proposals have triggered much debate in recent years. Last month, former Conservative cabinet minister Damian Green suggested that social care should be modelled on the state pension, with everyone entitled to a basic “safety net” of support to which they can add extra funding.

In a paper for free-market think-tank the Centre for Policy Studies, Green said: “Given you have this huge raft of wealth, particularly in housing, £1.6bn that people have in housing wealth - a sliver of that, frankly, used for social care would buy peace of mind in your old age and would get more money in the social care system.”

So what are all the main arguments for and against free elderly care?

Pros

Saving the NHS money

The IPPR claims that if its proposals were implemented, the NHS bill for providing “continuing healthcare” to those with high-level medical needs would “fall by £3.3bn, fewer hospital admissions would save £270m and improved end-of-life care in people’s homes would yield a further £267m saving”, The Guardian reports.

A fall in the number of patients who remain in a hospital bed despite being fit to leave would free up another £670m.

Cutting costs for the elderly

Social care costs around £13,000 a year for support in the recipient’s own home, or up to £44,000 if they move into a care home, The Daily Telegraph reports.

And a recent report by charity Independent Age found that more than 143,000 elderly people, or a third of the 421,000 in residential care, are likely to face bills of £100,000 or more.

Calling for the introduction of free personal care, the charity said that “free personal care... will end the worry of losing everything to fund care. It’s simple, fair and affordable.”

Public approval

Independent Age’s research found that 74% of people support free personal care for everyone who needs it, with 69% willing to pay more tax to fund such a scheme, reports the Daily Mirror.

Creating jobs

According to Sky News, another major benefit of full-scale funding of elderly care services would be a major boost to employment, with as many 70,000 new full-time jobs created under the IPPR’s proposals.

The think tank wants a “joined-up” system of health and social care in which GPs, nurses, mental health workers and social care workers would work locally in integrated teams.

Strengthening the welfare state

Welcoming the IPPR proposals, Sir David Behan, chair of Health Education England and former chief executive of the Care Quality Commission, said that the NHS should be free at the point of use for all citizens.

“In 1948, politicians were brave in making the NHS free at the point of need and funded out of general taxation,” he said. “We need our politicians today to be just as courageous and do the same for social care.”

Cons

Hefty expenses

According the IPPR, free care for the elderly would see taxpayer spending on adult social care for the over-65s rocket from £17bn per year in 2018-19 to £36bn in 2030 before NHS and other savings are factored in.

The think tank says £11bn of that increase would arise without the proposed changes, because of the growing elderly population - but this still leaves a hefty shortfall for the state.

Unfair burden on the young

Some critics argue that forcing everyone to pay more tax to fund something that a relatively small portion of the population is using is unfair. 

Steve Ellis, CEO of Legal & General Retail Retirement Living Solutions, insists that funding should not be the responsibility of everyone in the population, reports industry news site Care Home Professional.

“With Britain’s over-55s owning £1trn in housing wealth, the lifetime mortgage market is well placed to help retirees cover the costs of social care,” he said recently. “In today’s retirement where a generation is approaching later life cash-poor but asset rich, lifetime mortgages can provide people with the capability to remain in their homes and maintain their independence for longer.”

Tory MP Green echoed those sentiments last year, when he floated the idea that over-65s who own their homes outright could release equity from their properties to fund a national pot.

Others take a more nuanced view. Fellow Conservative politician Jacob Rees-Mogg has argued that although such care should be free at the point of use, the government should not impose an equal tax across all demographics.

Instead, he suggests a state-funded system where those receiving care pay an additional £5,000 a year each to help cover the costs.

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