The Care Bill is about to start its legislative scrutiny – initially in the Lords.  The Bill has some worthwhile parts and will not be as contentious and divisive as the Health and Social Care Act.  The real problems are not addressed.

Labour is still working out its position as regards how to fund adequate social care and even to adopt a free at the point of need approach as with healthcare.  But there is an immediate and growing crisis now in social care and the coalition is determined to try and divert our attention from this – since it does not intend to do anything about it.

Scope of the Bill

The Bill is intended to:-

  • implement the changes put forward by the Commission on the Funding of Care and Support (chaired by Andrew Dilnot)
  • meet the recommendations of the Law Commission in its report on Adult Social Care to consolidate and modernise existing care and support law
  • give effect to elements of the Government’s initial response to the Mid Staffordshire NHS Foundation Trust Public Inquiry (Francis Report)
  • take forward the necessary legislative measures for the establishment of Health Education England and the Health Research Authority as  non-departmental public bodies.

On face value, the measures in the Bill look like progress towards a fairer and simpler social care system, but in reality it represents a wider and dramatic failure to address the major problems confronting social care.  More older people afraid for their future; many seeing their social care support withdrawn; more struggling to pay spiralling care charges; far too many ending up in A&E or staying in hospital longer than necessary. The need to address the chronic lack of adequate funding and to set out a coherent policy to address the problems this causes is not acknowledged or addressed.

The Bill represents the response to Dilnot but given the announcements about the financial limits (not in the Bill) too few will benefit from the proposals and the over inflated claims made by the government are simply untrue. The Bill ignores the advice of Andrew Dilnot who warned that a cap would be ineffective without long-term funding of the baseline.  It is far from clear how the “market” to provide insurance based underpinning, anticipated by Dilnot, will somehow spring into life by 2016.

The Bill also hastily attempts to legislate for the government’s response to the Francis Report recommendations.  Again the government has made an inadequate response and failed to grasp the opportunity this presents, as pointed out by Robert Francis himself.

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