Funding of Care for Older People: A New Social Covenant (The Archbishop of York)
Writing an open letter to the Prime Minister and his fellow Taxpayers in England, the Archbishop has asked the Government to consider a new social covenant to protect the most vulnerable in society.
The Archbishop of York’s open letter follows…
Dear Prime Minister and fellow taxpayers in England,
At a recent Symposium held here at Bishopthorpe Palace, those who attended agreed that I write an open letter to you and to all my fellow taxpayers.
A time of economic crisis is a moment, not for social and economic retreat, but to build for the future. Her Majesty’s Government has rightly recognised the importance of building the economy in its recently announced National Infrastructure Programme. But we also need to strengthen the bonds that bind our community together, especially at a time when these are under particular strain.
A new social covenant is needed which – on the basis of an honest assessment of the respective roles of the State, voluntary associations and individual citizens – assures the weak and vulnerable of proper protection and gives all of us confidence that we are committed to building the conditions necessary to assist human flourishing.
Two groups – at either end of the age spectrum – deserve our particular attention. These are the young – whose nurturing, education and opportunities for employment are a particular concern, as on our success in securing these depends the quality of our community tomorrow –and older people, who form an increasing proportion of our population. In this letter to you, I want to focus on how we care about and for older people.
A society’s capacity to innovate is not independent of its capacity to understand and respect its own recent past. Older people are important connecting links to a world that still shapes our opportunities but which we can quickly fail to comprehend. The value we are seen to place on their wisdom and the concern we show for their care are important litmus tests of whether we can build a caring as well as a confident society in the 21st century.
In particular, the current adult care funding system in England is widely acknowledged to be unfit for purpose and to need urgent and lasting reform. The report of the Commission on Funding of Care and Support, chaired by Andrew Dilnot (the Dilnot Commission), published earlier this year, has shown us the way forward. Whether or not the political parties can come together to implement the Commission’s recommendations will be an important signal of our confidence and ability to build for the future of our society as well as of our economy, at this time of particular social as well as economic difficulty.
Valuing Older People
Each one of us – at every age in our life – is uniquely and equally precious in the sight of God. But what we each contribute to the richly hued tapestry of humanity will differ at different points of our life.
Medical advances mean that many older people today are able to remain active for longer. What those who are still active need is constructive occupation – not necessarily paid employment (which may come at the expense of the young) – through which they can both contribute from the wisdom of their experience and sustain a sense of being useful to others, and therefore of purpose.
What is most important in the actual experience of growing older is the slow change from an age of action to an age of reflection. While there is no evidence that other cultures care for older people more than we do, African and many non-Western societies more visibly care about older people. They value the wisdom of old age. That valuing is reflected in the Book of Proverbs: “The glory of young men is their strength, the splendour of old men is their grey hair” (Proverbs 20:29).
A failing of today’s society is to set the old over and against the young, in a state of mutual incomprehension. In fact, the old need the young and the young, the old. An integration of the generations is critical to a mutually supportive society.
A truly caring and Christian society is therefore one that sees older people, not as a growing and irrelevant burden, but as a rich treasure store of energy, experience and wisdom to be placed at the service of the young and of its future. Ensuring the conditions under which older people can make the special contribution of which they are capable is key to releasing this treasure. Providing a sustainable long term funding arrangement for the care of older people is a vital part of ensuring those conditions.
Why Reforming the Funding of the Care of Older People is Essential
Some key facts from the Dilnot Report, which will I know already be familiar to you:
a) In 1901 there were 61,000 people in the UK over the age of 85. Now there are almost one and a half million.
b) By 2030, the proportion of the UK population over 65 will exceed 20%.
c) Public expenditure in England on older people’s social care is not keeping up with demand.
d) Care costs for any one individual are uncertain and can, in some circumstances, be very high indeed.
e) The current system of funding individual care in England, which requires people with more than a very modest level of capital assets to use those assets to cover the cost of their care, leaves many in fear and uncertainty as they approach one of the most vulnerable periods of their life.
What is needed is a system for funding care which enables the risk to any one individual to be pooled, through taxation or insurance or, preferably, a mix of them both.
The Dilnot Commission has shown the way forward. It proposes a system under which the individual will be responsible, on a means-tested basis, for the costs of his or her care up to a suggested level of £35,000, after which the State would pick up the cost. The current asset threshold for those in residential care would also be extended, from £23,250 to £100,000.
Such a system will provide sufficient certainty to enable people to plan ahead, and allow the financial services industry to develop insurance and other products to help them with their planning. It will also help the poorest in our society the most.
The Commission estimates the cost to the public purse of its proposals at less than £2 billion. This is a large sum and I fully realise that, especially at a time of severe economic constraint, finding it will not be easy. But it compares with total annual Government expenditure of just under £700 billion. Moreover, if this investment in establishing a fairer system is not made, the cost of caring for older people falling on the NHS and other parts of the national budget is likely to go on increasing.
The Commission also recommends other sensible reforms, including a major information and advice campaign to help people plan ahead; better information and needs assessment for carers; and better integration of health and social care. These will be essential too if we are to strike the right balance between individual responsibility and publicly funded provision.
A Call to Action
We stand at a moment of serious social as well as economic crisis. At such a time, leadership of a particularly high order is called for. You, Prime Minister, and Her Majesty’s Government have shown your wish to provide such leadership, a leadership which is seen to address positively and constructively, in the wider interest, the fundamental issues facing our society. Reforming the system of funding the care of older people is one such issue. Dilnot has shown us the way forward. It is a call to action which our country cannot, must not ignore.
My fellow taxpayers, let us all back this clarion call to act now.
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