Dilnot report: A disservice to disabled and older people

A disabled activist

The 'independent' report, Fairer Care Funding, by the Dilnot commission has predictably failed to address the primary cause of the current crisis in social care - the underfunding of local authority social services by successive Tory and New Labour governments.

It has also brought forward the day when people will have to use private insurance to pay for their care and personal assistance needs.

According to economist Andrew Dilnot, and his colleagues Dame Jo Williams, chair of the Care Quality Commission, and former Labour health minister Lord Warner, the "current adult social care funding system in England is not fit for purpose and needs urgent and lasting reform."

They argue: "The current system is confusing, unfair and unsustainable. People are unable to plan ahead to meet their future care needs. Assessment processes are complex and opaque. Eligibility varies depending on where you live and there is no portability if you move between local authorities. Provision of information and advice is poor, and services often fail to join up. All this means that in many cases people do not have good experiences."

While there is some truth to these assertions, they do not arise from inherent fault lines within social care or its interaction with health services. Rather the current crisis is rooted in the failure to fully fund and implement section 2 of the Chronically Sick and Disabled Persons Act 1970 which places a duty on councils to provide services to disabled people in order to meet their needs.

Lifetime costs

Many newspaper headlines have focused on the Dilnot commission's proposals to 'cap' the lifetime costs of either home or residential care to £35,000 and raise the means test threshold for residential care to £100,000. But this is very thin icing on what is a very poisonous report if its recommendations are accepted by the Con-Dem government.

The commission supports the continuation of means-tested support for those with 'lower means', but contradictorily calls for free state support for young disabled people entering adulthood. It also suggests that people in residential care should pay between £7,000 and £10,000 a year for their 'board and lodgings'. If the latter idea becomes policy, how long would it be before it is applied to hospital-based care?

For social care, the commission believes minimum eligibility should be set at 'substantial' - an incredibly high threshold that would effectively mean the majority of disabled people and family carers of all ages being permanently excluded from social services. Laughably they would then be expected to turn towards the underfunded community sector and volunteers for vital help and support.

While the commission supports the continuation of universal benefits, it does not criticise the replacement of disability living allowance with personal independence payments - a policy designed to reduce the number of claimants by 20%.

The commission says between £1.3 billion and £2.2 billion is needed to implement its 'reforms'. But £1 billion has already been cut from social care this year alone, and the £350 million Independent Living Fund for those with the most complex needs is to close.

But the most dangerous part of this report lies in its support for the idea that there needs to be a 'partnership' between the individual and the state, ie people will be expected to save through their working life to pay for the first £35,000 or so of care costs in later life.

This will necessitate the development of financial products such as private insurance or savings schemes.

How will young people today with the high cost of pensions, mortgages or rent, and student loans and tuition fees to payback, be able to save the amount the Dilnot commission is proposing before the state steps in?

Dilnot, Williams and Warner have performed a disservice to disabled and older people, family carers and the working class, and should be condemned for this. The anti-cuts movement must take up this issue and demand that decent care be a right for all who need it.