The Tories' 'dementia tax' wobble is a reminder that the devil is always in the detail
Those of you playing along with the Theresa May stock phrases bingo must be close to a full house with the launch of the Conservative manifesto
May says a strong economy and delivering Brexit are top priorities. The get out of jail card being that all other policies are dependent on a successful Brexit negotiation.
The 2015 pledge not to raise income tax or National Insurance has been dropped and there are big changes to social care funding in England including how the elderly will pay for care in their own homes.
Fear has always been one of the most powerful persuasion tools in the sultans of spin’s armoury. Fear of terrorism. Fear of having our private data exposed through cyber attacks. Fear for the environment. Fear of not having enough money to buy food, health or heat. Fear of losing our homes. Fear of getting old. Combine these fears and the red tops burst a blood vessel.
The Conservative manifesto pledge to reform social care has polluted the front pages since launch. The media has been armed with appropriate soundbites from all sides including labelling the proposal a "dementia tax" and – as per the National Pensioners’ Convention – a “Frankenstein’s monster of a plan”
The negative media coverage also appears to have had a dramatic effect on the polls. The results of a YouGov survey now puts the Tories down to 44% with Labour up to 33%, news that saw the Sunday Times screaming on its front page: “Tory wobble as cuts for elderly slash May’s lead”. Ministers have “privately” (ie those without a spine to speak publicly) expressed fears that May’s plans to means test the winter fuel allowance and reform the care system would cost seats.
Jeremy Corbyn – Labour leader for the next few weeks – has been cashing in on the Tory woes by issuing a five-point pledge to pensioners, promising to preserve the triple lock and winter fuel allowance as well as prevent further rises in the state pension age.
Corbyn’s hopes of clinging to the leadership have been boosted by the poll, but Tom Baldwin, the former sultan of spin for Ed Miliband, said the Labour leader should “have the good grace to clear his desk the next day … if he cannot win seats from the Tories and cut their majority.” He went on: “Corbyn has never been a force for stability or rational debate in the party.”
Alarm bells should ring when spin doctors try to denigrate former clients and colleagues like real doctors betraying the trust of their patients. If they try to rubbish clients and colleagues, just imagine what they say about you behind your back… (coming soon: ‘When spin doctors go bad’.)
So let's separate the facts from the rhetoric ....
Theresa May has just created a political minefield for her government if/when she wins the June election.
Social care in later years – organised by councils – covers everything from assistance in a person’s home for tasks such as washing and dressing, to round-the-clock help in a care home or nursing home.
The way the system works is different depending on which part of the UK the person lives in.
Unlike the NHS, services are not free. Some people aged 65 and over will get help towards their costs but others will need to pay the full cost.
Under Mrs May’s proposals, over-65s with assets of more than £100,000 – including the value of their home – will be charged for domiciliary assistance. The current rules state that anyone with assets of £23,250 or more has to meet all their care costs – ie the elderly will now be able to save more than four times as much before having to pay for their own care. Many are asset rich but cash poor.
With a population which is living longer and longer, care for pensioners is set to balloon and May is obviously attempting to limit spiralling healthcare costs across the board. Social care provided by local authorities accounts for 55% of their budgets at present. Cuts in recent years to central government funding has meant cuts in other local services such as libraries and leisure centres.
At the same time, the cost of care homes has escalated, forcing the closure of local authority and privately-run care homes. The knock-on effect of this has caused severe bed-blocking in NHS hospitals.
It is predicted that in another 30 years almost 25% of the UK’s population will be over 65.
The social care system was set up in 1948 and has hardly changed since. Various governments have tried to address the problem: the Blair government set up a Royal Commission, but its recommendations came to nought. Gordon Brown floated the idea of a basic level of care for everyone, but that was killed off by the Tories’ “death tax” election campaign warning. The coalition proposed a cap on care, due to come into effect in 2016 but put back to 2020.
We all agree that care for the elderly should be a fundamental right. The question is who funds the cost of that care?
The Tory proposal is that if a person can afford to pay themselves they should. Labour‘s solution appears to be to pass on the obligation.
It would certainly help the electorate if each issue were to be broken down in this way with each option clearly stated.
The knock-on effects and risks should also be clearly explained so that informed decisions can be made rather than choices based on dramatic headlines.
So what chance has May’s proposal?
At present, Age Concern estimates that 20% of care is provided by local authorities with a further 12.5% paying for their individual care. This leaves nearly 70% with little or no care or being looked after by family and friends. The number in this group has risen by 50% in the last six years to 1.2 million.
The fear is that care homes and local authorities will see it as a golden opportunity to increase charges. At the moment, the average fees for a week’s stay in a care home for an individual is £618, while a local council only pays £486. The figures for a nursing home vary similarly with the council being charged £608 a week, and an individual being charged £740. The accusation is that private residents are subsidising the fees being paid by local authorities.
Without details there are several questions unanswered:
- Who is going to regulate/monitor the future fees charged by care home providers who may see elderly, vulnerable individuals, who are asset rich but cash poor, as rich revenue streams?
- If, as the Tories propose, no one will be forced to sell their home to pay for care will care homes be able to charge interest on the money owing, and at what rate, possibly having to wait many years to be paid? The same applies to organisations providing care in the home.
- So, will the Land Registry suddenly be inundated with requests for charging orders on people’s homes from those providing social care?
- Who will pay for the care of people who don’t own a home and live in rented property?
- Where will that money come from?
Prompted by questions such as these, May has made an apparent U-turn today, saying there would indeed be a cap on care costs. If that was always the intention, it should have been stated clearly in the same way as the £100,000 floor.
Fail to plan and you plan to fail...
The opposition and media have wasted no time in mocking May, pointing out that she does not look so strong and stable now and the U-turn undermines the Tories’ reputation for financial competence as a cap would cost billions....
What much of the media seem to have missed are some of the other pledges buried in the Tory manifesto, such as its commitment to “reduce loneliness and promote technological solutions to prolong independent living and invest in dementia research” (see page 65). Again, the devil is in the detail.
If the Tories are to reverse the decreasing lead, they need to provide clarity regarding these pledges. Are there really differences in the policies or simply in how they are to be funded? Let's get away from just the slogans and focus on detailed proposals so informed decisions can be made.
Whatever your views, we should encourage everyone to question everything and to vote.
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