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Social care rules aim to end 'postcode lottery' Social care rules aim to end 'postcode lottery'
(about 4 hours later)
The government is attempting to end the "postcode lottery" over care for elderly and disabled people in England.The government is attempting to end the "postcode lottery" over care for elderly and disabled people in England.
Under new draft rules all councils in England would have to fund services for those whose judged to have "substantial" needs, from 2015.Under new draft rules all councils in England would have to fund services for those whose judged to have "substantial" needs, from 2015.
The government says most councils do this already and the threshold is just a "starting point" for them.
Charities say it is too high and would exclude hundreds of thousands of people who need help with everyday tasks.Charities say it is too high and would exclude hundreds of thousands of people who need help with everyday tasks.
And councils say they want assurances that any extra costs incurred will be fully funded.
Local Authorities run social care services, such as home help with washing, eating and dressing or residential care, and decide who they will provide them to and whether they will pay for them.Local Authorities run social care services, such as home help with washing, eating and dressing or residential care, and decide who they will provide them to and whether they will pay for them.
Little consistencyLittle consistency
Councils can assess people as having "critical", "substantial", "moderate" or "low" needs. Councils can assess people as having "critical", "substantial", "moderate" or "low" needs. Only four councils provide care for people in all four categories - 16 councils fund those with "moderate" needs while most, 130, only fund those with "substantial" or "critical" needs.
The majority of councils, 130, provide services to those with "substantial" needs, while 16 also support those with "moderate" needs and three provide care for people in all four categories. Three councils only fund those with in highest category.
But three councils only fund help for those assessed to have "critical" needs.
The government says a national minimum would stop councils reducing services due to budget cuts and would level out variations between local authorities.The government says a national minimum would stop councils reducing services due to budget cuts and would level out variations between local authorities.
Mr Lamb said the draft regulations, which are being published for discussion ahead of a formal consultation next year, would set the minimum threshold at "substantial" - the level at which most councils currently operate. Mr Lamb said the draft regulations, which are being published for discussion ahead of a formal consultation next year, would set the minimum threshold at "substantial" - the level at which most councils currently operate. That would be a "starting point for local councils to base their care provision on".
Under the draft regulations, adults who are unable to carry out basic personal and household tasks without putting themselves at risk are among those who would be eligible for funded care.Under the draft regulations, adults who are unable to carry out basic personal and household tasks without putting themselves at risk are among those who would be eligible for funded care.
Starting point But Age UK's Michelle Mitchell said it would effectively set the minimum level too high and exclude hundreds of thousands of elderly people with moderate needs. She welcomed the move to introduce national criteria - but said the minimum level should be set at those with "moderate" needs.
Mr Lamb said: "We know people are often confused about what care they can expect from their local authority and far too many end up having to fight for the care that they need because the rules are so complicated. "Although this may sound like a technicality the final decision about these criteria is crucial.
"In my view, we need to be clear about the basic minimum entitlements to services so that everyone can be reassured there is some level of support they can expect, regardless of where they live. 'Shut out'
"A national minimum is exactly that - a starting point for local councils to base their care provision on." "As it stands millions of older people and their families who have assumed they will benefit from the government's social care reforms will miss out. But there is still time for the government to change their minds and Age UK will be campaigning to persuade them to do so."
But Age UK's Michelle Mitchell said it would effectively set the minimum level too high and exclude hundreds of thousands of elderly people with moderate needs. Richard Hawkes, head of the disability charity Scope, said the aim of ending the "postcode lottery" was welcome but added: "Under the proposals more than a hundred thousand disabled people who need care to get up, get washed and dressed and get out would be shut out of the system. "
"If the government is contemplating further reducing the already inadequate access to the system, then we believe many older people and their families will feel shocked and deeply disappointed. Mr Lamb told the BBC councils would still be required to provide broader preventative services for those with moderate needs and to give practical guidance and support to everyone who was assessed.
"The impact of further raising the bar to entry not only means that those on a low income will have to have higher care needs to benefit from state funded help, but also mean that those with hard earned savings will not be able to benefit from the future cap on care costs unless they are assessed as having needs equivalent to substantial." He said there would be a system of appeal for those denied social care if they believed they should be eligible. And he said assessments would be "broadly similar to what has happened in the past, but it will be this national basis so that local authorities won't be able to work out their own way of doing it".
And Richard Hawkes, head of the disability charity Scope, said the aim of ending the "postcode lottery" was welcome but added: "Under the proposals more than a hundred thousand disabled people who need care to get up, get washed and dressed and get out would be shut out of the system. "Beyond that, we're also starting work on trying to make these assessments more sophisticated to try to find ways of providing help earlier to stop your condition deteriorating," he added.
"The government has ignored disabled and older people, it's ignored public opinion and it's ignored the experts who are calling for a more preventative system to take pressure off A&E."
Councils currently spend about £16bn on social care but have had to trim the amount they spend in recent years because of spending cuts.Councils currently spend about £16bn on social care but have had to trim the amount they spend in recent years because of spending cuts.
In the Spending Review this week, George Osborne announced plans to put more money from the NHS budget into social care provided by local authorities to stop people falling "between the cracks" in the two services.In the Spending Review this week, George Osborne announced plans to put more money from the NHS budget into social care provided by local authorities to stop people falling "between the cracks" in the two services.
A spokesman for the Local Government Association, which represents councils, said most councils had to prioritise those in the greatest need or "risk going bankrupt" - owing to rising demand and "chronic underfunding".
"There's no point providing clarity over who is eligible for care if the money isn't in the system to then provide appropriate, effective and responsive services," he said.
He said councils needed assurances that the government's definition of "substantial" care needs would be "equivalent to the current level outlined by councils, and that any additional costs of implementing the new system will be fully funded".