Free Personal CareIssues from the Survey

John JacksonCo-Chair Resources Network

Headlines from the survey• Costs will be significantly more than the

Government has assumed• Minimum cost of the order of £1 billion• Financial risks exclusively borne by local

government• …thus costs will double for us (may be more)• Impact looks likely to vary significantly across the

country• Publishing our figures has informed the public

debate and led to an informed discussion with DH

Financial Implications – 4 areas• the loss of income from those currently paying for their

care;• the costs of providing care to those who are currently

arranging their own care, or paying for residential care or who are doing without care because they do not want to pay for that care;

• the costs of offering re-ablement to all those with the highest levels of need;

• the costs of assessing new people who come forward or reviewing the circumstances of all those receiving care who currently self fund.

Income• Results from the survey are the least reliable

part of the survey.• We used a figure of £209m• Subsequent discussions with DH: alternative

way of calculating possible cost using PSSEX1• Our calculations are that the loss of income is a

minimum of £154m (probably more)

Number of service users• Used the figures in the Impact Assessment• Discussions with DH: numbers of older people

are well founded• Number of younger adults are unknown• It appears that they are assuming 100,000

people already known to us (with 10,000 making a contribution)

• Possibly 10,000 coming forward who are not known to us. Do we have any better idea?

Costs of care• Key area of disagreement with DH• They are assuming that care for those with the highest

needs can be done in 8 hours (not 6.54)• Survey median hours: 14 OP; 20 Younger Adults• We used lower quartile 11 and 14 hours = costs of

£160/£204 week• Most authorities do not appear to have included double

handed care in their calculations• RAS figure is higher - £209/week• We intend to stick with our figures which are a minimum

Revised Minimum Costs

£m

Income 154

Costs of care older people 447

Costs of care younger adults 106

Re-ablement 130

Administration 27

Total 864

ADASS position• We have always used the lower figure where there

is a choice• Actual costs very likely to be higher – possibly

much higher• Our stance:

“mimimum costs of free personal care are of the order of £1 billion and possibly more than this" 

• Risk is with us. £1 billion means that we pay £580m compared with to £250m – more than twice as much

Other issues: funding• Only minority of respondents had included in

budget at time of response• Efficiency savings assumption is a breach of

new burdens protocol• It looks likely that the financial implications will

vary enormously from area to area (even ignoring costs)

• Can the grant systems cope?

Other issues: eligibility• Many people will not benefit• It is free personal care not free social care• Boundaries between personal and non-personal

care• Mental health problems• Not simple or transparent (key principles in

Green Paper)• Incentive to use residential care

Other issues: re-ablement• We will welcome this• Age Concern, etc are concerned about possible

compulsion• Need for more work on this with them

Other issues: behaviour• Currently focus on responsibility. Carers feel

responsible for looking after their relatives• Free care may mean a move to rights which

may affect carer behaviour and lead to less personal care input from them

• “Cost” of carer input is huge in financial terms (tens of £ billions)

Other issues: timescales• Government plan: 1st October• Tool only available in June• Staff training and systems work• Huge number of assessments• Backlogs inevitable; service user/carer

dissatisfaction• LGA pushing for 1st April 2011

An alternative approach• Fixed sum per week for all those eligible• Could be £100/week on top of attendance

allowance (£70/£47 per week)• Limited financial risk to either the Government

or local authorities• Consistent with the partnership model from the

Green Paper• Political acceptability?

ADASS Business Unit

Local Government House

Smith Square

London SW1P 3HZ

Tel: 020 7072 7433

Fax: 020 7863 9133EMAIL: team@adass.org.uk WEB:

www.adass.org.uk