Andrew Dilnot offers a clever solution to a deeply embedded problem, but…

One, it does not apply to Northern Ireland, and two the costs attached may prevent the current Lib Dem Conservative coalition from bring it in… So what’s the problem? In an unwieldly phrase: the under regulated economic burden of long term illness falling directly upon the personal estate of those affected.

Emma Stone at the Rowntree Foundation which commissioned the report:

The big surprise in today’s report is the extended means test for residential (not home-based) care. In 2007, JRF called for the very low threshold of £23k (liquid assets including housing assets) to be doubled, in order to prevent people with modest assets having to lose the lion’s share of their life’s savings to pay for care.

Today, Dilnot has called for the means-test threshold for residential care to be quadrupled to £100k – thereby immediately making the system feel much fairer for large swathes of home-owners in England.

The combined effect of the ‘cap’ and the ‘extended means-test’ for residential care should also benefit people with lower or modest assets more, as under the current system they are liable to lose a larger proportion of their accumulated assets, should they need residential care, than most of their more affluent peers.

This could be seen as a middle England (aka Tory voter protection move), except that the structure of home ownership have changed massively in the last thirty years or so, not least since so many council house tenants where given bargain basement offers to buy out their own homes.

But it is a potential equitable solution to a major hole in health care cover, since this is one of the few areas you cannot cover through private insurance provision. In practice, so long as the hospital agrees you require round the clock hospital support, the state will pick up the bill.

Once you are out, and into residential care the clock runs down on whatever assets you may have accumulated over the years.

The question is does anyone have an appetite to increase the overall cost of public services at a time when those services are being cut? And secondarily, does any political party in Northern Ireland dare to go where the UK government apparently fears to tread?

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  • aquifer

    Large assets tumbling down the generations, depending on the duration of random hiseases and accidents on the road and in marriage, is a really silly way to decide who gets unearned financial advantage.

    Our house prices are silly, so could we swap some certainty for uncertainty, like insurance, but getting a fixed contribution to care, however long it lasts, in return for a set share of a house value?

    Otherwise them what’s got gets more.

  • Ben Brogan, for the Telegraph, spells out why it won’t happen:

    We should take the praise that will be lavished on Dilnot with a dose of salt. David Cameron and George Osborne will try hard to avoid any language that might be interpreted as equivocal. But the £2-£3bn cost – rising to £5bn after 10 years apparently – is making them very nervous, as is the inescapable implication of what Dilnot proposes: the beneficiaries will be people with assets to protect, and the political minds in No 10 worry that some will conclude that Dilnot is an expensive way of helping mainly Tory voters. Forget that it also means those with no assets will get their care for free. In an age of austerity, there is great nervousness about lavishing money on those who have it already, as it were. Which is why Team Dave are talking up the need for consensus and want to see what Ed Miliband will say… “It’s DOA, there’s no doubt about it,” one Cabinet minister tells me. “At a time like this we simply can’t afford it. We’ll have to return to this issue at a future date.”

    What should not be forgotten, either, is that there are partisan scores to settle. In the last parliament there was touching-distance to just such a solution, until the Tories (i.e. Mastermind “Gids” Osborne) collapsed any hope of a consensus. There are all sorts of reasons why the Tories hierarchs will feel that, with the devolved administrations, especially the SNP, going their own ways, this is one that comes emblazoned Nemo me impune lacessit.

    So, here’s a prediction:

    The Brit, even the Engleeze, is losing enthusiasm for foreign wars — indeed for anything beyond the grog-shops of Calais. A clever left-of-centre strategy would propound that a retreat from sub-World Power status can be combined with a caring, sharing Social Democratic welfare model. Watch, then, for future Labour (+SNP, + Plaid, + non-Orange Bookers) to be preaching subtle versions of a new peace dividend — it’s that clear pinkish water that the Left needs.