The coalition fails to rise to the challenge on social care

The £75,000 cap on costs planned by the government will help just 10 per cent of those needing care.

More than 18 months after Andrew Dilnot's landmark report into social care was published, the coalition will finally unveil its planned reforms today. In a statement to the Commons, Jeremy Hunt will announce that the government will introduce a cap of £75,000 on care costs and increase the threshold for means-tested support from £23,250 to £123,000, so that no one with assets worth less than this amount is forced to pay. The £1bn-a-year cost of the plan will be met through higher national insurance contributions on employers and a six-year freeze in the inheritance tax threshold at £325,000 (George Osborne's famous 2007 pledge to increase it to £1m now being a distant memory of a pre-austerity age). 

The first point to note about the £75,000 cap is that under the coalition's timetable it won't actually be introduced until April 2017. Thus, as shadow care minister Liz Kendall has noted, it "won't do anything for the hundreds of thousands of elderly and disabled people who are facing a desperate daily struggle to get the care and support they need right now".

In addition, the cap, which excludes food and accommodation costs (typically around £7,000-£10,000 a year), is set a significantly higher level than that recommended by Dilnot. His report called for a cap of between £25,000 and £50,000 (settling on a figure of £35,000) and warned that anything outside of this range "would not meet our criteria of fairness or sustainability". A cap above £50,000 "could mean people with lower incomes and lower wealth would not receive adequate protection." Even if we adjust the £75,000 cap for inflation (it is based on 2017 price levels), that still leaves it at £61,000 - £11,000 higher than Dilnot's recommended maximum.

Interviewed on the Today programme this morning, Dilnot said that he regretted the coalition's decision to opt for a £75,000 cap but recognised that "the public finances are in a pretty tricky state". By capping costs for the first time, the plan would still "radically reduce anxiety", he argued. But others have been less generous. 

Labour has pointed out that since it will take the average person around four years before they reach the cap, it will not benefit the majority of patients, most of whom don't make it this far. Dot Gibson, the general secretary of the National Pensioners Convention, estimates that the proposals will help "just 10 per cent of those needing care". Labour is currently developing its own social care plan as part of its policy review but is likely to recommend a cap no greater than £50,000. 

The government's hope is that a cap of £75,000 will encourage insurers to offer policies to cover costs below this amount. As Hunt said on The Andrew Marr Show yesterday, "We don't want anyone to pay anything at all. By setting an upper limit to how much people have to pay, then it makes it possible for insurance companies to offer policies for people to have options on their pensions so that anything you pay under the cap is covered."

But Labour is highlighting the fact that Nick Starling, the director of general insurance and health at the Association of British Insurers, has previously dismissed this as wishful thinking. He told the health select committee in November 2011: "I do not think there will be pre-funded products. That is unlikely. I speak on behalf of the insurance industry, but I bring independence in the sense that, except for the immediate needs annuities which [Chris] Mr Horlick [of Care Partnership Assurance] provides, there are no products out there. I am not grinding a particular axe about particular forms of products. I am saying that, in a sense, we have a chance to think in quite an open way, unencumbered by a whole forest of products already out there. In that sense, the thinking we have been doing on this is independent."

A cap on costs is, as Dilnot suggested, better than no cap at all. But unless Hunt springs a surprise on MPs today, it is already clear that this will not be a lasting solution to the care problem. For that, one suspects, we will have to wait for a change of government.  

Health Secretary Jeremy Hunt will announce the government's planned social care reforms today.

George Eaton is political editor of the New Statesman.

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Air pollution: 5 steps to vanquishing an invisible killer

A new report looks at the economics of air pollution. 

110, 150, 520... These chilling statistics are the number of deaths attributable to particulate air pollution for the cities of Southampton, Nottingham and Birmingham in 2010 respectively. Or how about 40,000 - that is the total number of UK deaths per year that are attributable the combined effects of particulate matter (PM2.5) and Nitrogen Oxides (NOx).

This situation sucks, to say the very least. But while there are no dramatic images to stir up action, these deaths are preventable and we know their cause. Road traffic is the worst culprit. Traffic is responsible for 80 per cent of NOx on high pollution roads, with diesel engines contributing the bulk of the problem.

Now a new report by ResPublica has compiled a list of ways that city councils around the UK can help. The report argues that: “The onus is on cities to create plans that can meet the health and economic challenge within a short time-frame, and identify what they need from national government to do so.”

This is a diplomatic way of saying that current government action on the subject does not go far enough – and that cities must help prod them into gear. That includes poking holes in the government’s proposed plans for new “Clean Air Zones”.

Here are just five of the ways the report suggests letting the light in and the pollution out:

1. Clean up the draft Clean Air Zones framework

Last October, the government set out its draft plans for new Clean Air Zones in the UK’s five most polluted cities, Birmingham, Derby, Leeds, Nottingham and Southampton (excluding London - where other plans are afoot). These zones will charge “polluting” vehicles to enter and can be implemented with varying levels of intensity, with three options that include cars and one that does not.

But the report argues that there is still too much potential for polluters to play dirty with the rules. Car-charging zones must be mandatory for all cities that breach the current EU standards, the report argues (not just the suggested five). Otherwise national operators who own fleets of vehicles could simply relocate outdated buses or taxis to places where they don’t have to pay.  

Different vehicles should fall under the same rules, the report added. Otherwise, taking your car rather than the bus could suddenly seem like the cost-saving option.

2. Vouchers to vouch-safe the project’s success

The government is exploring a scrappage scheme for diesel cars, to help get the worst and oldest polluting vehicles off the road. But as the report points out, blanket scrappage could simply put a whole load of new fossil-fuel cars on the road.

Instead, ResPublica suggests using the revenue from the Clean Air Zone charges, plus hiked vehicle registration fees, to create “Pollution Reduction Vouchers”.

Low-income households with older cars, that would be liable to charging, could then use the vouchers to help secure alternative transport, buy a new and compliant car, or retrofit their existing vehicle with new technology.

3. Extend Vehicle Excise Duty

Vehicle Excise Duty is currently only tiered by how much CO2 pollution a car creates for the first year. After that it becomes a flat rate for all cars under £40,000. The report suggests changing this so that the most polluting vehicles for CO2, NOx and PM2.5 continue to pay higher rates throughout their life span.

For ClientEarth CEO James Thornton, changes to vehicle excise duty are key to moving people onto cleaner modes of transport: “We need a network of clean air zones to keep the most polluting diesel vehicles from the most polluted parts of our towns and cities and incentives such as a targeted scrappage scheme and changes to vehicle excise duty to move people onto cleaner modes of transport.”

4. Repurposed car parks

You would think city bosses would want less cars in the centre of town. But while less cars is good news for oxygen-breathers, it is bad news for city budgets reliant on parking charges. But using car parks to tap into new revenue from property development and joint ventures could help cities reverse this thinking.

5. Prioritise public awareness

Charge zones can be understandably unpopular. In 2008, a referendum in Manchester defeated the idea of congestion charging. So a big effort is needed to raise public awareness of the health crisis our roads have caused. Metro mayors should outline pollution plans in their manifestos, the report suggests. And cities can take advantage of their existing assets. For example in London there are plans to use electronics in the Underground to update travellers on the air pollution levels.

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Change is already in the air. Southampton has used money from the Local Sustainable Travel Fund to run a successful messaging campaign. And in 2011 Nottingham City Council became the first city to implement a Workplace Parking levy – a scheme which has raised £35.3m to help extend its tram system, upgrade the station and purchase electric buses.

But many more “air necessities” are needed before we can forget about pollution’s worry and its strife.  

 

India Bourke is an environment writer and editorial assistant at the New Statesman.