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Seeking answers to questions about the care system

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Hopes that Dilnot Commission had produced an answer to the one of the biggest policy challenges of our generation - how to pay for the success of longevity - have been dashed by the government’s progress report on the funding of care and support.

Commitment to the commission’s proposals is  limited to its ‘principles’ of a capped cost approach, a dilution of homeopathic proportions. The intention to base a funding system on those principles carries the caveat ‘if a way to pay for it can be found’. That must wait the next spending review, timetable unknown.

With no prospect of reform this side of the next general election. Councils are left holding the baby and council finance directors will be busy preparing their own version of Barnet’s ‘graph of doom’ (see above diagram) if they haven’t done so already.

It’s worth noting as well that the introduction of a national minimum eligibility threshold from 2015 will remove the principal tool councils have for managing the widening gap between needs and resources. With 82% already limiting help at ‘substantial’ levels of need, far from heralding an end to the postcode lottery, this change will simply close the door long after the horse has bolted.

Many of the proposals in the Care and Support White Paper welcome – bringing the hotpotch of social care legislation into a modern statute for the 21st century is long overdue.

But despite the hundreds of pages published last week, answers to the big four questions remain incomplete - what kind of care system do want to fund ? what will it cost; how are they shared fairly between individuals and the state; and – crucially - where does the money come from ? Newcastle is the latest council setting up a commission to seek out its own answers to some of these questions. It’s unlikely to be the last.

Richard Humphries, senior fellow, The King’s Fund

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