Green Paper Shaping the Future of Care Together

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Green Paper Shaping the Future of Care Together

• David Behan
• Director General for Social Care,
• Local Government Care Partnerships,
• Department of Health

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Shaping the Future of Care TogetherCNO Business
Meeting23 24 September 2009

• David Behan
• Director General for Social Care,
• Local Government and Care Partnerships

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Why we need to change

• In 1948, life expectancy was 66 for men and 71
  for women. Today it is 77 for men and 82 for
  women.
• We are an ageing society. For the first time
  ever there are more people over the age of 65
  than there are under the age of 18.
• There are currently around four people of working
  age for every person retired. By 2059, this
  ratio will almost halve.
• 1.7 million more people with care needs by 2026.
• Expectations are increasing

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A National Care Service Our Vision

• This Green Paper sets out a vision for a
  National Care Service. As we all know, more and
  more of us are living longer and thats a good
  thing, but the current care system was designed
  in the 1940s, and we need to develop a system
  that fits our needs in the 21st Century. We need
  a system thats fairer, simpler and more
  affordable for all of us. One that ensures you
  get really good care wherever you live and
  provides whatever you or your family needs. So
  this is the beginning of a big care debate.

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A National Care Service for all adults in England

• People want to be treated fairly.
• The system needs to be simple.
• It needs to be affordable for everyone.
• Designed for all adults

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What people should be able to expect
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How the system needs to change
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Paying for the National Care Service

• 2 in 3 women and 1 in 3 men will need high levels
  of care in their life
• The average cost of care for a 65 year old is
  30,000 during retirement
• 1 in 5 will need care costing less than 1,000
  but 1in 5 will need care costing more than
  50,000

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Paying for the National Care Service

• Most people 18-64 will be funded from general
  taxation
• The vast majority of the increase in costs will
  come from people over 65
• So we have looked at different funding options
  for the over 65s.

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How we could fund the National Care Service

• We have looked at five ways in which care and
  support could be funded and we have ruled out two
  of these.
• Pay For Yourself - Everyone would have to pay
  for themselves with no state support this
  option is ruled out
• Partnership People will be supported by the
  Government for around a quarter to a third of the
  cost of their care, more if they have a low
  income.
• Insurance As well as receiving a quarter to a
  third of the cost of their care, the Government
  would also make it easier for people to take out
  insurance to cover their remaining costs.
• Comprehensive Everyone gets care free when they
  need it in return for paying a contribution into
  a state insurance scheme whether or not they need
  care.
• Tax Funded Full cost of care is met through
  taxation this option is ruled out

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Pay for Yourself

• As a society we want to care for older people,
  including those who have neither the means or/nor
  the family to care for themselves.

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Tax Funded

• The enormous burden of taxation that this would
  place on those of working age

2059
2009


working
working
65
65
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The current system
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The options
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Ways to contribute

• Lump sum on retirement
• Defer state pension
• Instalments throughout retirement
• Pay out of estate (defer until death)
• Or a mixture of the options
• In time regular contributions throughout
  working life

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The Cost of Care

• Accommodation costs are not included
• Some disability benefits for the over 65s could
  be included
• Care is still guaranteed for those people who
  cant afford to pay

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A Nationally or Locally determined funding scheme

• Role of Local Authority
• Be the channel for state funding
• Undertake assessments
• Provide information, advice, advocacy and care
  management
• Provide and commission services and develop the
  market
• Foster innovation to decide how services are to
  be delivered

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A Fairer Universal System

• What
• everyone who needs care can get it regardless of
  where
• they live
• How
• Through a National and portable assessment
• National eligibility
• The level of funding through the Partnership model

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Options

• Part national/part local
• Local Authority decide how much to be spent on
  care
• Fully national system
• Government would decide how much to be spent on
  care
• Implications for local government finance

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Question 1 the Vision

• We want to build a National Care System that is
  fair, simple and affordable. We think that in
  this new system there are six things that you
  should be able to expect
• Prevention services
• National assessment
• A joined-up service
• Information and advice
• Personalised care and support
• Fair funding
• Is there anything missing from this approach?
• How should this work?

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Question 2 Making it a reality

• We think that in order to make the National Care
  Service work, we will need services which are
  joined up, give you choice around what kind of
  care you get, and are high quality.
• Do you agree?
• What would this look like in practice?
• What are the barriers to making this happen?

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Question 3 - Funding

• The Government is suggesting three ways in which
  the National Care Service could be funded in the
  future
• Partnership People will be supported by the
  Government for around a quarter to a third of the
  cost of their care, more if they have a low
  income.
• Insurance As well as receiving a quarter to a
  third of the cost of their care, the Government
  would also make it easier for people to take out
  insurance to cover their remaining costs.
• Comprehensive Everyone gets care free when they
  need it in return for paying a contribution into
  a state insurance scheme whether or not they need
  care.
• Which of these options do you prefer, and why?
• Should local government say how much money people
  get depending on the situation in their area or
  should national government decide?

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Find out more

• Visit www.careandsupport.direct.gov.uk
• or look for us on facebook

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We want your views

• We are holding a public consultation until 13
  November 2009, on the questions raised in
  Shaping the Future of Care Together.
• It asks for your views on some difficult choices
  that we need to make for this vision to become a
  reality.
• Get involved in our Regional Programme. Hold
  your own event or attend one of the 36 sessions
  taking place throughout England.
• Join the Big Care Debate and help Shape the
  Future of Care Together

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