by
Les May
WHEN
Theresa
May
called a General Election in 2017 one proposal in the Tory Manifesto
was immediately dubbed a ‘Dementia
Tax’.
At
present councils
pay for all or part of a person’s social care if they have less
than £23,250 in capital.
This applies if a person is in a residential home or nursing home.
The cost is then recouped from their estate after their death. May
also wanted to recover from
their estate the
costs of care given to people in their own home, to raise the
protected sum
to £100,000 and
axe the Winter Fuel Allowance for more affluent pensioners.
These
proposals went down like the proverbial ‘lead
balloon’.
They
were attacked by both Labour and the Liberal Democrats. The
Tories could reasonably argue that this was a better deal for
relatively poorer people who needed residential care and
would mean that the costs of care given in the home would be recouped
only
from
the more wealthy. Strictly speaking of course that’s not quite
true.
Until someone finds a foolproof, (and fire proof?) way of putting
‘pockets
in a shroud’
it will be the beneficiaries
of the estate
who will have their inheritance reduced.
Social
care today is in the same state as health care was in the 1930s, a
hodgepodge of partly national and partly local provision, and funded
partly by those who have the misfortune to need long term care, often
with pressure applied to their spouse or family, and partly from the
public purse. Unlike the NHS which is ‘free
at the point of delivery’
social care is not built around a ‘shared
risk model’.
Such
a model would
recognise that throughout
our life we
all
run a small risk of requiring
social
and
residential care
due to age, infirmity or accident, hence we should all
make a contribution to funding that
care
for those who need it.
The
simplest and
most effective way
of doing this is via the tax system. But here we have a choice we
can either raise the money through a tax on income or through a tax
on wealth, specifically
a
tax on inherited
wealth. When
the costs of care are recouped after
someone’s death the burden falls on the estate not
the deceased individual. If you doubt this you might like to
consider that a dead person does
not
own their own body, so
how can they be said to own property or
other assets?
Switching
to such a funding model would go much further than Labour’s 2010
proposal for a ‘National
Care Service’.
Labour shied away from a fully tax funded system as being too costly
to be a sustainable model on
the basis that it would put too high a financial burden on the
decreasing proportion of the population that is of working age (p126
below).
I fail
to see that a tax based upon inherited wealth would not be
sustainable.
The
distinction between social (or personal) care and medically required
care is an artificial one. Dementia is a chronic medical condition;
it results in sufferers requiring social care in their own home. Why
should the necessary care for both the condition and its side effects
not come from the same source?
May’s
‘crime’
was to try to have an adult conversation with people who prefer not
to think about the problem of funding care for older people and send
to parliament people who are similarly reluctant to talk about it.
In
2019 the lesson was learned, no
one wanted a caning for talking out of turn.
The
Tories pledged an extra £1bn, the Lib Dems £3bn and Labour £10bn
by 2024 to
fund in home social care for all who needed it and to ensure that
carers were paid at least £10 an hour with no ‘zero
hours contracts’.
These
are significant sums of money, but even Labour’s proposals leave
the question of funding residential care for those who need it
unresolved. This
matters because the available funding has an impact on the quality of
care which is provided. Nothing illustrates this more sharply than
the spectacle of the owners of ‘run
for profit’
residential homes asking to be provided with kit to protect staff and
residents against coronavirus, and being told it is their
responsibility.
We
need a politician with vision and determination to keep fighting for
a universal and comprehensive care model for those who need it due to
age or a chronic medical condition funded by a tax on inherited
wealth, in the face of short sighted claims that it is a ‘death
tax’
or a ‘tax
on the sick’.
As I said earlier, ‘there’s
no pockets in a shroud’.
Even
though I am unlikely to be the recipient of inherited wealth it seems
to me it would
be
better to have the
certainty 80%
of something rather than run the risk of 100% of nothing!
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