Andy Burnham insists home care bill is affordable

Appearing in front of the Commons health select committee last week, Mr Burnham insisted the bill, which will give free homecare to those with “critical” personal care needs even if they are well off, was affordable.

The problem is they are heaping on more costs and saying you can make more savings. You wonder whether that’s a sustainable position

The government believes the provision will cost £670m a year - a maximum £420m coming from existing Department of Health budgets, with the estimated £250m remainder coming from additional local government “efficiency savings”.

But many believe the cost will be far greater. Labour peer Lord Lipsey, a former member of the Royal Commission on Long Term Care, said last year the bill was unaffordable, comparing it to an “admiral firing an Exocet into his own warship”.

Mr Burnham told MPs last week: “Categorisation of the bill as an Exocet is 100 per cent wrong.”

He said the DH portion of the funding would come from “reconsolidating” its research budget and reducing communications and consultancy funds.

Asked whether public health campaigns would lose cash, he admitted there was “no easy trade-off”.

He insisted the bill would give “more support to the most vulnerable” and build a more preventive care system.

However, one PCT chief executive who did not want to be named told HSJ: “The problem is they are heaping on more costs and saying you can make more savings. You wonder whether that’s a sustainable position.”

King’s Fund senior fellow of social care Richard Humphries commented: “The idea that a cost we don’t know is going to be picked up through local authority efficiency savings stretches credulity.”

Local Government Association strategic lead for adult social care Andrew Cozens described the cost as an “unquantifiable burden”.

He said councils did not know how many people were making arrangements for their own care at present but could get it free under the new system.

Mr Cozens also predicted that users with critical needs would have less incentive for their support to be deemed “continuing care”, which is funded by the NHS, as council services could also be free.

Referring to the relationship between PCTs and councils, Mr Cozens said: “This reopens all the difficulties we’ve had over the years on defining continuing care. It extends the territory of uncertainty to include those with critical personal care needs.”

But Ealing PCT chief executive Robert Creighton said: “We’ve anticipated for some time that budgetary pressures on both health and social care will intensify but we are confident that we’ve put in place processes and procedures to manage that maturely without resorting to cost shifting.”

Speaking to HSJ after the hearing, Mr Burnham suggested the social care white paper would not be published until March.

He told MPs the white paper would go against “a lot of fashionable talk in recent times about localism and giving people the ability to run things at a local level”.

“I think often people don’t want that in areas like social care. They don’t want a postcode lottery in healthcare and, when it comes to social care, they want clarity about what they can expect and they want it to be fair across all areas,” he said.

HSJ is hosting a free to view webcast on Developing Infrastructure to Deliver World Class Integrated Care at 9.30am on 19 January. Register at www.hsj-integratedinfrastructure.com