Policy 2: Health & Social Care & Three Possible Solutions.
The abiding problem of Kent County Council is that nobody wants to pay for it. When council tax or business rates go up we get sensational headlines and outrage inevitably follows, as the comments in the Kentonline piece makes clear.
Health & Social Care in Kent received a welcome boost recently when the extra 2% KCC were allowed to raise on the Council tax, meant that they could ring fence this money just for Health & Social Care. This money will not be enough though to meet the whole budget.
Solutions are needed and I can personally think of three.
1 – Linking NHS and social care funding to a minimum share of GDP, which would encourage preventative investment and aid long-term planning by protecting funding from short-term shifts in the political climate.
2 – Better use of demographic data. The biggest unknown when it comes to the demographic future is migration. Will families with babies continue to move from the local flats as their children become mobile? Will the high income families that have established gentrified inner-city enclaves remain there as they age? Will the next group of immigrants swept to Britain by war or economic competition settle in the same urban places?
The trick for KCC planners is to distinguish how much of future demographic change is predetermined, how much is effectively uncertain and unpredictable, and how much can be seriously influenced – and then to plan accordingly. KCC’s mantra should be: predict what is not under their control, plan what is under their control.
3 – Deferred Payments Agreements
Care homes places are largely in demand by people in Kent who are over the age of 75, a group with considerable housing wealth. Many, however, will struggle to access this capital as houses are a ‘lumpy’ asset: it is easier to sell half of your shares than half your home. Equity release products are available on the private market, but these can be expensive and not everyone is eligible.
Through deferred payment agreements (DPAs), the state offers a solution to this problem. Under such arrangements, a local authority postpones invoicing care fees in exchange for a claim on the participant’s housing equity. This money, plus interest, is then recouped, typically after the participant passes away. I agree it is not a perfect solution, but when there are no other solutions being put forward, it is better than none.
Since councils recover loans from people’s housing equity, they do not have to spend taxpayers’ money to finance the scheme in the medium term. Deferred payment agreements, therefore, align with the KCC’s alleged commitment to fiscal sustainability and responsibility.
Restricted eligibility is the main reason why deferred payment agreements have failed to take off. Set at £23,250, the means test prevents too many people from accessing the scheme. The government should therefore consider extending this form of support to people with moderate savings. A limit of £75,000 – £125,000 would increase eligibility by 40 to 50%.
The impact of social policy on population trends reflects not only on the number of people but on households,the main unit of consumption and expenditure. The time that youngsters stay with parents before setting up their own home has been lengthening. The feasibility of paying for a care home without spending one’s entire wealth has diminished, adding pressure to care in the home by relatives or others.
I know for some these will not be palatable ideas, nor am I suggesting these are the only ideas and/or solutions, but political parties are short termists and all too often put politics ahead of people. When it comes to our grandparents health & social care and our own, we can no longer treat this as a political football and keep kicking these problems down the line.
Politics is as J.K. Galibraith said, a choice between the disastrous and unpleasant, and as unpleasant as these ideas/suggestions may be, at least I have the courage of my convictions to spell them out to you.
By voting for me in the forthcoming KCC elections on May 4th I will engage with the ruling party and ask them to kick these proposals up to central government for serious consideration and to improve the health & social care planning which is absolutely necessary.
Vote Independent – Vote Bryan Rylands – Folkestone West
May 4th 2017
Published & Promoted by Bryan Rylands Flat D Avenay Court Folkestone CT20 2LN
All the information above is my own and does not represent the views of the Shepwayvox Team who have kindly allowed me to use their blogsite.
The problem I see with ‘DPA’ is that this kicks the problem down the road for the next generation to deal with, as the younger generation (in this area) are struggling to buy properties and therefore when they get to OAP age they probably won’t have a house to defer.
My suggestions:-
1. All Care Homes should be nationalised.. Fees can then be sent as per NHS Dentist charges – no more profiteering and the NHS have ONE national standard.
2. Care Home staff should be (a) properly qualified to NVQ 3-4 and (b) paid a ‘qualified person’ rate. Apprenticeships should be included with obligatory training up to NVQ 3-4 standards through local colleges – no more cheap rate staff working long hours or zero hour contracts
3. Fund all this properly with a 1-2% rise in National Health Insurance conributions with no upper threshold – the rise should be ring fenced to the NHS for Social Care.
4. Remove District Council responsibility for local Social Care – give that to the local NHS Trusts who could be responsible for maintaining the National Standards and also for moving Home Care users towards Care Homes if required.
Well Done Bryan. These are far better suggestion than what the Tories have proposed. Good Luck and you’ve got my vote as I live in your division.
are you going to have a public meeting if not is there any way of meeting up with you.
i do like you ideas and like to understand them better.
I hope to have a public meeting, but finding the time is difficult. You can always email here and I’ll do my best to respond to your questions Krishna
I don’t know if this is too simplistic an idea, but I will give it a go.
This is for people who own their homes.
If they need to go into a residential or a nursing home they rent their property to the council, the rent they get goes towards paying for the care and the council will have the much needed housing.
If there is a small short fall in paying the care cost the government should help pay the difference, that is the least they can do to reward people who have worked hard all their lives and have been thrifty and saved up and managed to buy a house.
And I guess the family will still have a home to inherit.
Hi Krishna, maybe simplistic but a viable option which could be explored, as there are potential legal implications, but if they could be overcome, then I see no reason as to why the idea couldn’t be worked up into a policy and possibly implemented.
What do you think.
According to some radio programs I have heard them mention how much more the agency Nurses and Doctors cost, what if all the hospitals stop employing agency staff? The agency staff would have to find the jobs in their chosen profession through direct recruitment for the NHS.
Obviously this has to be planned in plenty of time and the agency staff made aware and given a chance to have a job in place.
This way the NHS should be able to employ more staff at decent pay.