Questions have been raised over the details of the prime minister’s pledge yesterday to provide free personal care for those most in need.
In his speech yesterday to the Labour Party conference, Gordon Brown said: “For those with the highest needs we will now offer in their own homes free personal care.”
Annual spending of £670m would work out at just £38 of care a week for each of the 350,000 people – far short of the estimated £165 cost of the average 11-hour package of domiciliary care provided in 2007
There is not yet clarity over how many people this pledge will benefit - or how it will be funded.
A Department of Health spokeswoman said the measure would be an interim one implemented from October next year while the government developed plans for a new national care service.
She said: “From October 2010 the NHS and local authorities will end the means test on care at home for the 350,000 people with the greatest care needs who currently pay for these services.”
Labour Party officials told the Financial Times the move would cost around £670m a year, of which £400m would come from the Department of Health budget for “advertising and marketing and ‘lower priority’ research and IT”. The remainder would come from local authorities.
The DH has so far been unable to confirm the figures and they have caused some confusion. King’s Fund senior fellow Richard Humphries said: “What do they mean by ‘personal care’ and how do ‘highest needs’ get decided?”
Annual spending of £670m would work out at just £38 of care a week for each of the 350,000 people – far short of the estimated £165 cost of the average 11-hour package of domiciliary care provided in 2007.
But government sources have told HSJ that many of the 350,000 people who would get free care from next October were currently being charged for it. However in the majority of cases they were not being charged the full cost of their care but were paying only what the means test said they could afford.
According to the latest NHS Information Centre statistics, 346,700 adults received council-arranged care in their own homes in 2007, costing a gross £2.6bn. Those services are currently means tested, but only 12 per cent of the gross cost is covered by user charges.
If the government abolished the means test for those 346,700 it would cost the public purse an extra £312m a year.
But figures given to the government by the Personal Social Sciences Research Unit based at the London School of Economics suggested that by 2010 there would be 933,000 elderly people in the highest “critical needs” category for social care.
A number of them would be cared for informally by their friends and family, the researchers said, but that would still leave 647,000 who needed care either in their own home or in residential care homes.
Assuming care home residents stay constant at around 450,000, that would leave just under 200,000 adults requiring their critical needs to be met through domiciliary care in their own home.
Providing that, on an average care package of 11 hours a week, would cost some £1.7bn a year.