Paying for Domiciliary Care

On Monday morning this week, I ‘launched’ a social care conference, arranged by TLC, a local service delivery company, at Llanidloes.  I think it was rather grandly described as a ‘Keynote Speech’. I refer to this only because my main message was much the same as that heading up today’s front page in the Telegraph. My contention was that Domiciliary Care ‘service users’, (those who can afford to that is) must pay more for their care. It’s what the Social Care Minister, Jackie Doyle-Price is reported to have said at a fringe meeting at the recent Conservative Party Conference. Hope I’m supporting the Minister’s and the Government’s emerging policy on this issue. I’ll summarise the thrust of my speech.

I began by acknowledging that paying for social care is both a complex and controversial issue. It’s arguable that a Conservative attempt to tackle the issue in June’s manifesto contributed to a more disappointing election result than I hoped for. The description of the policy as a ‘Dementia Tax’ was an utter disgrace - repeated in today’s Telegraph. The Telegraph, and every other media outlet that does the same should be ashamed of themselves. It’s a policy area that is in desperate need of reform. It is deeply unfair is several ways. The people who pay for this failure to tackle a very thorny issue are the frail elderly, whose voice is not heard as much as it should be in today’s society.

Firstly, let’s consider the difference between how residential care and domicilliary care are treated. Those who need care pay for residential care, until the value of their assets fall to a certain level. Those who are deemed to qualify for domiciliary care don’t. Not only is this unfair, but it distorts decision making amongst families. And we know that assets are sometimes transferred in cases where the need for care can by anticipated.

Secondly, in the absence of magic money trees, domiciliary care is paid for by taxpayers, often much less wealthy. It simply seems wrong to me that young families, struggling financially to bring up children have to support people far wealthier receive care.
I agreed with the Conservative manifesto proposal (after it was amended to include a ‘cap’ on the total paid. It was payable by ‘service users’ who were worth more than £100,000. In my view the ‘cap’ on total payments should be less than £100,000. And payment should be deferred until after the used dies.
I know this is not likely to be a popular viewpoint. But as I’ve grown older, I think it’s more important to be right, responsible and fair that it is to be ‘popular’. The second key message of my speech on Monday was that as new policy is developed (which it will have to be) it should developed in partnership with representatives of those who use the services and those who deliver the care. This is not an issue that can be left, simply because it’s difficult. And there are commentators who will do their utmost to make it an impossible to tackle it.