Phil Hope, Minister for Care Services, spent an hour answering questions on the Government’s plans to introduce more choice, control and personalisation in health and social care.
- Read more about the big care debate.
Read the transcript:
Moderator says: Phil Hope has just arrived at Downing Street and will begin answering your questions shortly.
Phil says: Hi, I’m Phil Hope, Minister for Care Services. I am delighted to be here today to answer your questions on the future of the care and support system and I hope to answer as many of your questions as I can.
Mark Edgecombe: Hi Phil. Can you clarify something for me? I’m always puzzled about the definition of ’social care’ as opposed to ‘health care’. What is the difference between them given that both types of care are the cause of the same illness? Thanks.
Phil replies: Hi Mark, you’re right that there can be confusion about what counts as social care and what counts as healthcare. As you know, healthcare is medical care provided free at the point of need through the NHS which is funded through general taxation, but social care is the support given to people to help them with everyday living such as help with dressing, washing and eating. This is provided by local authorities, voluntary organisations and the private sector to people at home or in residential settings and is a means tested system.
P Stevenson: I have a relative that through illness cannot care for herself yet has to pay for the care she receives, the illness is not cancer or a heart condition as the care is free but dementia, please could you provide an explanation for this discrimination
Phil replies: Dementia is a very cruel disesase but we know we can help people to live with this condition for many years. People with dementia may have healthcare needs which are provided for through the NHS, e.g. for drug treatment and social care needs which are provided for through the social care system and which, depending on your income, may have to paid for by the individual themselves. We are currently considering a major reform of our care services to create a national care service which is fair, simple and affordable. I recently published our National Dementia Strategy which aims to improve the way that people are diagnosed at an earlier stage with earlier intervention and support.
fred williams: Why are you and your government making disabled people poorer by taking away the Attendant Allowance to feed the NHS. Disabled people need that allowance to live. Disabled people are the poorest in the country and you want to make them ever poorer.
Phil replies: Fred I can assure you that we are not taking away anyone’s Attendance Allowance. If we reform the care and support system to create a National Care Service, then all people receiving Attendance Allowance at the time of reform will continue to receive the same level of support. There will be no cash losers. However, we think there is a good case for combining our care and support systems to create a better system for everyone for the future.
Nicola Lloyd: How are these new initiatives going to be funded with an already overstretched NHS?
Phil replies: Nicola this is a really important question because we have an ageing population, there will be more demands upon the system and we estimate there will be 1.7 million more people than today by 2026. That’s why we are proposing to create a National Care Service in which more people are given help to live independently in their own homes, there is more investment in care services to prevent people going into hospital and residential care and there is more integration between health and social care services so that people receive better quality care and we get the best value for money from the huge investment that we are now making in our health and social care services.
Deirdre Krymer: Will users who do not want personalised budgets be able to retain direct service delivery?
Phil replies: Deirdre, the short answer is yes. The longer answer is that everyone I’ve met who receives their care through a direct payment or a personal budget has really been enthusiastic about the control and choice it gives them over the kind of care that they receive. I would like to see everyone have the choice of a personalised budget in the future and ensuring that services are tailored to meet the specific needs of individuals will be at the heart of our new National Care Service.
Phill: Hi, I am a graduate and have been looking to find a job in social care since last summer but everywhere is asking for experience. I have tried getting in as a volunteer but there aren’t many places and I am worried that such a placement will affect my job seekers allowance. Any recommendations?
Phil replies: Phill, I think it’s great that you want to join our social care workforce. We are very keen to attract new people into a career in caring and we are launching today a major new recruitment campaign to attract more people into the caring profession. This includes graduates, people leaving school or college and people wishing to make a career switch from their exisiting job. For more information do visit our website. I would encourage anyone who wants to get experience of caring to join the huge number of volunteers who already do a fantastic job in our care services. Please check out with the advisors at Job Centre Plus if you have any concerns about any effect of volunteering on your allowances.
Natalie Williamson: What exactly will be available to service users in the reablement package proposed in the Personal Care at Home Bill? If adaptations and telecare are assessed to be integral in enabling an elderly person to remain at home through the reablement package how do the government propose to deliver these services in six weeks? As there is no clarity in the consultation on this it is impossible to determine the impact of this bill on existing services, including the work currently being undertaken by home improvement agencies who are already delivering reablement in a variety of ways. If we take it that telecare and adaptations are not included as part of the reablement package but rather, the reablement package identifies the need to provide these services and individuals are then referred on to other service providers,the potential implications of the delays this will incur in terms of reducing the care needs of these people needs to considered. For example, would a person waiting for an adaptation receive free personal care (providing they meet the eligibility criteria) whilst they were waiting for the adaptation to be completed?
Phil replies: Natalie, I think it’s really important that people get help with living independently and safely in their own homes, particularly if they have recently had an operation. We call this reablement care. I call it getting back on your feet. This is something that the Prime Minister spoke about enthusiastically yesterday and is a key part of our Personal Care at Home Bill. It will include adaptations and telecare in your home if that’s what you need. I would like to see the excellent practice that exists in some parts of the country repeated everywhere so that everyone has the chance to receive a reablement package tailored to their needs.
Phil replies: Natalie, I think it’s really important that people get help with living independently and safely in their own homes, particularly if they have recently had an operation. We call this reablement care. I call it getting back on your feet. This is something that the Prime Minister spoke about enthusiastically yesterday and is a key part of our Personal Care at Home Bill. It will include adaptations and telecare in your home if that’s what you need. I would like to see the excellent practice that exists in some parts of the country repeated everywhere so that everyone has the chance to receive a reablement package tailored to their needs.
Linda: what plans are there for social inclusion for physically disabled adults.
Phil replies: Linda, I think it is absolutely essential that all adults with care needs can live the life that they want to live and be able to contribute to and be a full part of their community. This for me is a fundamental principle that will underpin the new National Care Service.
Tracie Noon: the job of carer will need to be made more profesional if more dementia suffers are to be cared for in thier homes what will be put into place to make sure this happens, Im a scheme manager of a sheltered housing and see what effect poor carers have on dementia sufferers.
Phil replies: Tracie, I believe that informal carers play a vital role in giving support to people with social care needs. We published our ten-year Carers Strategy in 2008 and an early area for action was to improve the amount and quality of respite care for people who take on the role of caring for a loved one. Our future National Care Service will have carers and families at its heart to ensure that people who carry out this important role are given the support they need. The paid care workforce is now around 1.5 million people and we are taking forward a new strategy to raise their skills and give them the support they need to do their very demanding job as well as possible. From this April, the Care Quality Commission will be introducing a new registration scheme for all providers to ensure that minimum standards of care are provided for people at home and in residential care.
Gerry: Is is fair to those older people who have the greatest needs, i.e. those in residential/nursing care, that they will have to pay for personal care whilst those in their own homes, with less needs, will get it free?
Phil replies: Gerry, everyone I talk to says that they want to live for as long as possible in their own homes rather than go into residential care. Our Personal Care at Home Bill will provide free care for those people in the most need living in their own homes. It is these people who have often run down many of their savings already who have the most needs and for whom their family is providing a lot of care and support. We think it is right to give more help to people in these circumstances and to reduce the numbers of people who might have to go into residential care as a result. This new measure is an important step towards creating a National Care Service.
Paul Clarke: Question: It seems we will continue to have an ageing population for some time. Are we being bold enough in planning for the longer term care consequences this presents?
Phil replies: Paul, you are right to identify the challenge of an ageing population where we will move from four adults of working age to every pensioner now to two adults for every pensioner by 2026. There will be 1.7 million more adults needing care in the future. I see an ageing population as an opportunity, not a threat, as we will have more people with knowledge, skills and experience who can make an active contribution to a fairer society. But fundamental reform of our current care and support system will be needed. That is why we will be setting out our plans for creating a National Care Service that rises to this challenge. While we have improved elements of the system in the past, the time now is for fundamental and wholesale reform.
janet McCarter: Most people would agree that free personal care is the ideal – but how will it be paid for, as the cost is likely to increase year on year.
Phil replies: Janet, the question of funding personal care is crucial both now and for the future. The costs of providing free personal care at home for those in most need is estimated to be £670 million with part of this (£420 million) coming from the Government and the rest from efficiency savings across local government. For the longer term, we need more radical reform and we will be spelling out our proposals on this in the near future. Free personal care for people in most need in their own homes is one of the building blocks towards creating a new National Care Service.
K Wheeler: What is going to happen to the very cost effective Attendance Allowancel This will be greatly missed if it is scrapped as would appear to be the case
Phil replies: I know that many people are concerned about the Attendance Allowance so let me say again that if we reform the care and support system, anybody receiving Attendance Allowance at the time of reform will receive the same level of cash support. There will be no cash losers. We think there is a case of bringing together some benefits such as Attendance Allowance and care funding to deliver a better joined up service. So we are not scrapping Attendance Allowance as some have claimed, but I believe we can provide better care and support for the future.
Claire Wood: Hi I have a very serious condition and I’m caring for someone with Dementia but we live together, we’re mother and daughter. Will she have to sell her home to pay for her care? Where does that leave me as this is my home too.
Phil replies: Claire, one of the big unfairnesses that people feel about the system at present is that they have to run down their savings or sell their homes to pay for their care. It’s a system that has existed since 1948 when the National Health Service was created and is long overdue for reform. We want to create a new National Care Service that is fair, simple and affordable. I would like to see a system in which people who have worked hard, saved up and bought their own house do not have to worry about losing their inheritance to pay for care costs.
Jasmine Warwick: I’m concerned that in the midst of going through a vitally important consultation on future social care funding, the Prime Minister announced his intention to offer free personal care. This discouraged participants in the consultation and has made me feel that all that work was not worthwhile because you are going ahead with your own decision regardless of what we might have said. At least let us see the results of the consultation.
Phil replies: Jasmine, I believe it is right that as well as drawing up long term plans for fundamental reform of the whole system we should take action now to help those in most need. Over the last few years we have been developing a number of key changes to improve the care system as building blocks towards a new National Care Service. Putting People First, which is a £500 million programme of funding for local government to transform local care services, our Carer Strategy, the Dementia Strategy and Valuing People Now – our strategy for people with learning difficulties – are all steps towards our long term goal which is a National Care Service. Offering free personal care to people in most need in their own homes is another key building block and in particular will help more people to receive packages of reablement care in their own home.
I am sorry but I have to go now. I hope I have addressed many of the different issues that so many of you have raised. It has been really helpful reading the concerns and thoughts that you all have and I am confident that as we bring our plans forward for creating a National Care Service you will see the commitment we have to creating a fairer system and better quality for all. If you would like to read more about any of these issues please visit the website. Thank you all for taking part.