Dilnot report


The Dilnot Report was published on 4th July 2011 and outlines the recommendations of the Commission on Funding of Care and Support. The independent commission, set up by the Government last July, was asked to recommend a fair and sustainable funding system for adult social care in England.

Here you can read the following information:

a) The recommendations in full
b) payingforcare.co.uk’s analysis
c) An expert view and analysis by Peter Barnett, Specialist Adviser to Baroness Greengross

a) The recommendations are given in full in the Commission’s report Fairer Care Funding.
The report is also available in an easy read version and pamphlet which gives a summary of the main recommendations.  To accompany the report there are two additional published volumes – Volume II Evidence and Analysis, and Volume III Supporting Documents.


Fairer Care Funding - Report (PDF)
Fairer Care Funding - Easy Read (PDF)
Fairer Care Funding Pamplet (PDF)
Volume II Evidence and Analysis (PDF)
Volume III Supporting Documents (PDF)
Presentation of Report Recommendations (PDF)

b) payingforcare.co.uk's Analysis

Overview:

The eagerly anticipated report by the Commission on Funding of Care and Support has been published today. The 81 page report outlines proposals for how best to deal with funding a growing ageing society. Among the main recommendations is the cap of individuals’ lifetime contributions toward their social care costs. The report states that once the cap is reached, individuals would be eligible for full state support. The report proposes that this cap should be set at £35,000. The report also recommends that the current means-tested threshold of assets should be increased to £100,000 from £23,250 and that there should be national eligibility criteria and portable assessments to ensure greater consistency. In order to support the Government’s call for more choice and control for service users, they believe that people must have different options for meeting their contributions, whether this is through their income or savings, releasing housing assets or through a specific financial product.

Detail:

The report is clear to state that the current funding system is not fit for purpose and that it requires urgent and lasting reform. It cites one of the main problems as the availability of financial products to support people in meeting care cost, which the Commission have stated is “very limited”. They believe that this means that there is great uncertainty and people often worry about the future. The report states that individuals are currently unable to protect themselves against the risk of very high care costs by “pooling their risk”. The report goes on to say that “this is the only major area in which everyone faces significant financial risk, but no one is able to protect themselves against it”.

In their report, the Commission have said that any reformed funding system should:

  • offer protection to everyone against the risk of high care costs and be clearer, helping people to plan and prepare, and encouraging saving;
  • support everyone in making their personal contribution by opening up a viable space for financial products, supporting carers and providing targeted state support; and
  • be better aligned with other elements of the care and support system to form a more streamlined and integrated system in which delivery is shaped around individuals, not services.

The key recommendations from the report are:

1. To protect people from extreme care costs we recommend capping the lifetime contribution to adult social care costs that any individual needs to make at between £25,000 and £50,000. We believe that £35K is an appropriate and fair contribution. Where an individual’s care costs exceed the cap, they would be eligible for full support from the state. This change should bring greater peace of mind and reduce anxiety, for both individuals and carers.

2. Not everyone will be able to afford to make their personal contribution, and those currently just outside the eligibility for means tested help are not adequately protected. To address this, means-tested support should continue for those of lower means, and the asset threshold for those in residential care beyond which no means tested help is given should increase from £23,250 to £100,000.

3. People born with a care and support need or who develop one in early life cannot be expected to have planned in the same way as older people. Those who enter adulthood already having a care and support need should immediately be eligible for free state support to meet their care needs, rather than being subjected to a means-test.

4. Universal disability benefits for people of all ages should continue as now. We recommend that the Government considers how better to align benefits with the reformed social care funding system and that Attendance Allowance should be re-branded to clarify its purpose.

5. People should contribute a standard amount to cover their general living costs, such as food and accommodation, in residential care. We believe that a figure in the range of £7,000 to £10,000 a year is appropriate. 

6. We recommend that eligibility criteria for service entitlement should be set on a standardised national basis to improve consistency and fairness across England and that there should be portability of assessments. In the short term, we think it is reasonable for a minimum eligibility threshold to be set nationally at ‘substantial’ under the current system[1]. The Government should also urgently develop a more objective eligibility and assessment framework.

7. To encourage people to plan ahead for their later life we recommend that the Government invests in an awareness campaign. This should inform people of the new system and the importance of planning ahead. This campaign could be linked into the wider work to encourage pension savings.

8. The Government should develop a major new information and advice strategy to help when care needs arise. It is critical that the public has access to better, easy-to-understand and reliable information and advice about services and funding sources. This strategy should be produced in partnership with charities, local government and the financial services sector. As proposed by the Law Commission, a statutory duty should be placed on local authorities to provide information, advice and assistance services in their areas. These should be available to all people irrespective of how their care is funded or provided.

9. Carers should be supported by improved assessments, which take place alongside the assessment of the person being cared for and which aim to ensure that the impact on the carer is manageable and sustainable. We support the proposals set out by the Law Commission to give carers new legal rights to services and improve carers’ assessments. In implementing our recommendations on information and advice, the Government should ensure that carers have better information and advice about support and available services.

10. In reforming the funding of social care, the Government should review the scope for improving the integration of adult social care with other services in the wider care and support system. In particular, we believe it is important that there is improved integration of health and social care in order to deliver better outcomes for individuals and value for money from the state.

Whilst the recommendations from Dilnot’s report have been welcomed as a whole by the sector, it is not without its critics, not least by those who fear that the Chancellor, George Osborne MP, will decide not to proceed with the recommendations given the extra £2billion required to fund the new system. Indeed, over the weekend an unnamed Liberal Democrat was quoted as saying that George Osborne will “strangle (the proposals) at birth” and a Cabinet minister reportedly told the Daily Telegraph that the proposals were “dead on arrival”. However, many in the media are reporting that the Secretary of State for Health, Andrew Lansley MP, will welcome the report, and in particular the cap on care costs. Although the report has been broadly welcomed, both Andrew Lansley MP and Paul Burstow MP, Minister for Care Services, have warned that the recommendations may not be popular with everyone.

The Leader of the Opposition, Ed Miliband MP, has himself offered to put aside his party’s policies and political aims to come together to form cross-party talks on this issue. This was broadly welcomed by Number 10, and we can therefore expect to see all parties push for a consensus.

Analysis by Insight Public Affairs.