We intend to keep the website available as a resource, but as the initiative has now come to an end we will be not be allowing comments to be added from Thursday, 19 June 2008. You can continue to play a part in the government consultation and have your say by visiting http://www.careandsupport.direct.gov.uk/

Video extracts from his speech and feedback from table discussions at the event are available on the King’s Fund website.

More than 700 older people, carers and others were invited to share their experiences and views at our events throughout 2007. This final report, which draws on the evidence heard from these discussions, as well as a survey of those who attended the events and input from web visitors, will conclude the collaboration’s programme of work.

Download The Future of Care Funding: Time for a change

Remember to leave your own comments at the bottom of the page.

Sue Collins, Principal Policy and Public Affairs Manager, Joseph Rowntree Foundation
Sue started off the day by giving a short talk on work being done by JRF on the social care system: why the current system, Plan A, isn’t working, and what the JRF’s Plan B would look like.
Listen to Sue Collins’ presentation (6 min 45 sec)

Panel discussion
The afternoon consisted of questions from delegates to a panel, consisting of:

• Ivan Lewis MP, Parliamentary Under Secretary of State for the Department of Health
• Norman Lamb MP, Shadow Health Secretary, Liberal Democrat Party
• Stephen O’Brien MP, Shadow Minister for Health, Conservative Party
• Vera Bolter, representative from the Elders’ Forum of Newcastle
• Professor Julien Forder, Deputy Director of Personal Social Services Research Unit, University of Kent and LSE

We have picked three questions and a selection of the responses for you to listen to.

Question on the Green Paper
The spending review promised that the Green Paper on adult social care would offer a radical rethink. The question is, how radical?
Listen to Norman Lamb’s response to how radical the rethink should be (2 min 39 sec)
Listen to Vera Bolter’s response to how radical the rethink should be (0 min 58 sec)
Listen to Ivan Lewis’ response to how radical the rethink should be (2 min 45 sec)

Question on supporting carers
Given that the value of unpaid care has risedn to what Carers UK has estimated to be £87 billion a year, how do you all see the role that carers will play in any future system and how will you adequately support them and reward them for what they do?
Listen to Norman Lamb on supporting and rewarding carers (2 min 24 sec)
Listen to Stephen O’Brien on supporting and rewarding carers (3 min 01 sec)
Ivan Lewis on the role of carers (4 min 03 sec)

Question on cross-party consensus
Can the government achieve cross-party consensus over fundamental reform and how will the panel judge the success of the reforms?
Can cross-party consensus be achieved? (3 min 25 sec)

As at previous Caring Choices events, almost everyone wanted the current means-tested social care system replaced but there was an acceptance that the financial responsibility for providing such care lies jointly with the individual/family and the state. More than 80 per cent of participants said that they would prefer a change to a ‘co-payment’ funding system, where all dependent older people would receive some support towards their care costs regardless of their income/assets, while also making a private contribution that was affordable for them.

There were repeated calls for the political parties to reach a consensus about reform. One panel member said: ‘We need an architecture for long-term care which is signed up to by all parties and the public and providers. People need a level playing field and a basis for rational decision at a time when they decide to save.’ Reform of the funding system, however, is no substitute for an increase in public spending on older people’s care, said participants.

There was agreement that reform must define ‘basic needs’ widely enough to preserve an individual’s dignity and that of their unpaid carers. Older people must have choice, regardless of their level of income/wealth, and any system should also consider preventative services and non-personal care needs, rather than only focusing narrowly on personal care services.

Read the full report from the Taunton event

The new funding system has won widespread approval in Scotland, but participants at the event voiced a number of concerns about how the policy is working. For instance, there remains considerable confusion among the public about what exactly is on offer from the state and a lack of understanding of how ‘free personal care’ operates and what services are covered. This is exacerbated by the big variations between local authorities in the implementation of the policy, leading to widespread complaints that a ‘postcode lottery’ still exists for older people’s care. Local authorities control the eligibility criteria for care and decide the size of a care package an individual needs, leading delegates to complain of unequal access to care and support across Scotland.

In a country with very varied geography and population densities, there can also be a problem of lack of choice regarding service options and delivery, especially in rural areas. In particular, older people sometimes do not have options for housing, with a shortage of care home places in some areas and generally a lack of flexible, accessible housing for those older people who want to continue to receive support in their own homes.

Despite the shortcomings, there was consensus among participants that the policy of free personal care, which currently accounts for around 1 per cent of the total Scottish Executive budget, is affordable in Scotland, although this proportion is projected to double over the longer term because of demographic trends.

Equity of service provision, better information, value for money, sharing innovative developments, and higher service quality emerged as the main issues that now need to be addressed if the policy is to achieve its goal of independence and well-being for older people. These issues were strikingly similar to those raised at the Caring Choices events in England, demonstrating that people’s main concerns often go beyond the question of the funding model. There are no easy solutions to the challenges, but it was agreed that putting the individual at the centre of the equation will be the key.

Read the full report from the Edinburgh event

King’s Fund response
Help the Aged response
Age Concern response

The King’s Fund has pulled together resources and commentary on the government’s plans for a Green Paper to reform the current system of social care.
View King’s Fund resources and commentary on the Green Paper

Once you’ve listened to the speeches, don’t forget to add your comments at the bottom of this page.

• Introduction by Niall Dickson, Chief Executive, King’s Fund (5 min, 44 sec)
• Julien Forder, London School of Economics (8 min, 11 sec)
• Paul Cann, Director of Policy, Help the Aged (3 min, 29 sec)
• Imelda Redmond, Chief Executive, Carers UK (6 min, 52 sec)
• Barbara Keeley, Labour MP for Worsley (9 min, 19 sec)
• Discussion (32 min, 22 sec)
• Listen to the whole event (60 mins).

Read article in the Guardian: ‘Radical plans for care have personal touch’

At the fourth Caring Choices day in Leeds on 13 September, views on the basic questions followed a familiar pattern.

Almost nobody thought the present system of paying for care is adequate. Nine in ten participants thought the cost of care is very likely to rise (and the rest agreed that this was ‘possible’). Most believed the government needed to play a key role in providing the necessary extra resources; almost nobody thought the state should stay out of paying for care. As at previous events, a majority felt that the government should not be paying for everything, with ‘co-payments’ from individuals and families playing a role – but a significant minority thought that all personal care should be provided free of charge. There was widespread agreement that the quality of care should be improved, and a strong accord that unpaid carers are undervalued and need to be better supported.

However, discussions around the design of a new system revealed a wide mix of opinion. The two aspects that caused greatest controversy were the position of personal care in the support system and the role of publicly supported partnerships to unlock private money.

Many participants supported the idea of channelling public support into a universal entitlement to personal care, potentially with a private co-payment. But there were differences in views about how costs can be shared, and considerable debate about what kind of care should be supported. Some participants were nervous of a system prioritising personal care over other care needs such as preventive services and services that improve quality of life. ‘Why distort resources towards personal care costs?’ they asked.

Many liked the idea of public–private partnerships to help unlock money for care, but others in Leeds feared that doing so would favour already well-off people unreasonably. Another cause of anxiety in this part of the debate related to mistrust of financial institutions, alongside uncertainty about whether the public sector can deliver believable guarantees.

Both these points seemed to suggest a need for flexibility, under which a basic guarantee from the state could be used in different ways by different people. In this sense, the Scottish system of focusing support on personal care packages may not necessarily be the best model; there was interest in exploring other countries’ models where a wider range of options may be available, particularly those where standardised needs-based assessments are the rationale for distribution of resources.

Read the full report from the Leeds event

Read full report of the event.

Caring Choices will also be holding a fringe event at the Labour party conference on 25 September.