Stockton-on-Tees Borough Council

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Cabinet Decision: 26th November 2009
Title of Item/Report
Green Paper - Shaping the Future of Care Together
Record of the Decision
Cabinet was advised of the content of the Green Paper entitled ‘Shaping the Future of Care Together' which set out the Government's vision for a new care system that was fit for the 21st Century; and was responsive to the changes in expectations and demographics of society.

The Green Paper, which was reflective of earlier consultation with the public, people who use services and people who work in care, found that rising aspirations demanded a better, fairer system of care and support both for those who look forward to a long and active old age, but who may need some support to stay well in their later years, and those who need some support earlier in their lives due to disability. The green paper reflected a view that the current system was a legacy of a series of incremental steps rather than a single planned creation, such as the National Health Service. Some people qualified for support through disability benefits. By contrast, means tested social care support was only provided to people on low incomes who could not afford to pay for themselves. Other people who were seen as being able to support themselves were expected to do so from their own resources such as savings and the value of their home if their savings or assets had a value of more than 23,000. A large number of people were expected to make provision for themselves and received little in the way of advice and support whilst having to make difficult and expensive decisions about care and support.

Beyond the above perceived unfairness, the current funding mechanism was seen as unsustainable because of the shifting demographics within society. This means that there will be considerably more people living into their later years and fewer people of working age. By 2026 it was likely that 1.7 million more adults would need care and support. Rising expectation means that they will expect more choice and control over their services. Failure to reform the system would also restrict the effectiveness of such initiatives as Putting People First and the personalisation agenda. A projection of the anticipated demographic changes was provided, including the likely demand for care and support services.

The principal proposal contained within the green paper was a new National Care Service which would incorporate a universal framework for care and support that was simple to understand. Its aim would be to support people to stay independent, and to provide services based on individual circumstances and need. The Government envisaged the new National Care Service being fully ‘joined up' with the NHS to help people receive more appropriate care in the right setting. Details of the key features of the Paper were summarised. The vast majority of responses to the Government's previous consultation process argued that everyone in society is responsible for ensuring people receive the care they need, including individuals, families, employers, communities and government. Almost everyone agreed that the Government should share care costs through a largely tax-based system. Three principles to determine how state resources are spent were put forward for further consultation:

Variation according to where people live: this was viewed as unfair by the majority of respondents because where someone lives should not influence what level of care they can receive;
Variation according to when someone develops a need: this is about whether there should be one system for everyone, or different systems based on the different needs people have. People were less concerned about how money is raised so long as individuals with different needs are entitled to the same outcomes.
Variation according to whether people are able to pay for their care: the paper reports mixed views with some people believing state funds should focus on people with greatest need (and lowest means), but others finding it unfair that those who save all their lives have to pay for themselves, whilst those who have never saved get their care for free.

In order to make the best use of existing funding, the Government had recognised that there were many different sources of money that were currently used to pay for care and support. Some were seen as working well, such as Supporting People and Disability Living Allowance. Other funding streams were seen to be used less well, for example Attendance Allowance (AA), which is not means tested. Five funding models were outlined as ways of bringing new money into the system: individuals paying for themselves; partnership; insurance; comprehensive; and tax funded. Of these, the Government had three preferred options for a funding model that was universal, helped everyone who needs care to pay for it, was fair and affordable and was simple and easy to understand. These were the partnership model, the comprehensive model, and the insurance model; the details of each were summarised.

The Government had posed 3 national consultation questions to gather the views of all stakeholders and had run a number of road shows (The Big Debate) to engage a range of views on these proposals. The deadline for responses was the 13 November 2009.

A policy briefing session for Members had been held on 2 November 2009 and a summary of the member comments received was considered. Responses from health and social care managers had been incorporated into the Primary Care Organisation response, which was also submitted.

The results of the consultation would be published in due course and a national leadership group would be established, bringing together the leading experts and organisations across care and support to drive forward changes and to resolve issues where clear differences remain. A white paper would then be published on care and support in 2010 with detailed proposals for implementing a new National Care Service offering care ands support for everyone.

RESOLVED that the response to the Consultation questions be noted.
Reasons for the Decision
To highlight the direction of travel outlined in the Green Paper and note the proposals outlined.
To ensure that Stockton's feedback was included in the national consultation process.
Alternative Options Considered and Rejected
Declared (Cabinet Member) Conflicts of Interest
Details of any Dispensations
Not applicable
Date and Time by which Call In must be executed
Not later than Midnight on Friday 4 December 2009

Date of Publication: 30 November 2009

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