If health and social care funding is combined, the reality of a “quicksand” foundation will be faster..

Perhaps the public need to feel and see the unreality of the situation regarding social care. With so many of the population ignoring their possible future needs, and health care being free, whilst social care is means tested, there is a perverse incentive for those making the decisions (who also hold the purse strings) to class as much as possible as “social”, and as little as possible as “medical”. The actuary is founded in reality, but even their solution only applies to 33% of us!

No wonder the people “ignore their future costs” when they have been told they can have (in health) Everything for everyone for ever. 

I have had several families as patients who have deliberately given away property in plenty of time to avoid the state getting their hands on their cash, and to ensure it all passes on to the next generation. Since inheritance tax is a double tax I am in favour of abolishing it, but that does not mean lucky people who live into their late 90s should avoid payments. The system needs to be altered, and to face reality.

Despite the warnings, especially from “Community Care” the politicians will not grasp the nettle. Homes are going to close. There are many areas of the country where the privately funded are so few that there is only one payment schedule. In richer areas the wealthy often subsidise the state funded clients….. its one of the questions needing asking when being admitted to a home and in my view, in the interests of openness, needs to be publicised on their internal notices, literature and website.

‘Your insurance doesn’t cover acts of God, like age related illness and accidents.’

Nick Triggle for BBC News 26th June reports: Care cuts inevitable in ‘fragile and failing’ system

The Actuary 25th June 2019 (They really do know) reports: Social care reforms proposed for third of UK population – Around a third of the UK population could benefit from targeted government incentives that boost saving for social care, the Pension Policy Institute (PPI) has proposed.

The Mirror reports that the social care time bomb is set to explode as millions ignore future costs entirely. 

Luke Haynes in “Community Care” opines 26th |June 2019: Worsening social care funding position wreaking increased human cost, warn directors – Numbers affected by home care provider closures double as fragile care market and NHS cost shifts exacerbate financial woes for councils

Update 26th June 2019: Next PM should lift constraints on public spending to fund social care like the NHS – report finds

( A report equally in the clouds of unreality. If we cannot afford the one for free, we cannot afford both! ) The BMJ opinion from Anita Charlesworth is well intentioned but unrealistic.

Dominic Brady in Public Finance reports: “Social Care heads are unsure that they can provide minimum finance…”

Anita Charlesworth in the BMJ opines: We need a social care system that is as much a source of national pride as the NHS

This entry was posted in A Personal View, Perverse Incentives, Post Code Lottery, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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