The government has laid out plans for a “National Care Service” (NCS), based on the principle of free personal care for everyone who needs it.
Although many of the proposals in its Building the National Care Service white paper drew praise, the government was fiercely criticised for postponing a decision on how its reforms would be funded.
Health secretary Andy Burnham described the proposals as “bold and ambitious”, an “historic announcement” and “the biggest change to the welfare state since 1948”.
He pledged “nationally consistent” criteria that will state at which point a person becomes eligible for support, and “portable” assessments, so disabled people could move to a different part of England and not face a reassessment of their needs.
Burnham said care would be free at the point of use for everyone who needed it, giving disabled and older people “choice and control over their own care and their own lives”.
He also promised to “push forward” with the personalisation of services. By April 2012, everyone approaching a council for support will receive a personal budget.
And he said the government would not help fund its reforms by scrapping attendance allowance (AA) and disability living allowance for those over 65 – at least for the lifetime of the next parliament.
Burnham said this was because of the strong opposition to such proposals from disabled people and other campaigners during the government’s “Big Care Debate”. The white paper’s equality impact assessment goes even further and says the NCS will be built around AA and DLA, “maintaining these benefits as a flexible form of support”.
Other pledges include “accurate, relevant and accessible” information about entitlements and assessments, and easier access to both social care and disability benefits.
The first stage of reform will be introducing free personal care at home for those with the highest needs, through the personal care at home bill.
The government hopes that two key concessions on the bill – delaying its implementation until April 2011 and agreeing that MPs and peers would have to approve its implementation after it became law – will be enough to secure its passage through the Lords.
The second stage of the reforms, from 2014, will see those staying in residential care for longer than two years receiving free personal care.
The government will also set up a commission to recommend the “fairest and most sustainable” way to fund the NCS and a “leadership group” of “expert stakeholders” to advise on implementing its reforms, and introduce an NCS bill early in the next parliament.
The final stage of reform will be the full introduction of the NCS with a new funding system, soon after the next but one general election.
The white paper is at www.dh.gov.uk
1 April 2010