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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To think it’s not fair that we cut public services so that older adults pay less for care?

159 replies

Bristol2021 · 03/11/2023 13:58

I work in a local authority which is facing an unprecedented budget deficit, like most councils across the country. Most of the deficit is due to the government demanding that councils pay the ‘fair cost of care’ - demanding they negotiate with local care providers so that the same rate is charged to councils as to people paying out of pocket (who are not eligible for free care). This brings the cost to private payers down a bit, but raises the cost to most councils by £tens of millions. As a result all councils are having to cut hundreds or thousands of jobs, and cut back any services (things like arts and leisure, homelessness prevention, remaining children’s centres) to what is required by law, and lower standards of what’s left. This is all so that relatively affluent older adults pay less out of pocket for care. Those people still get the lifetime cap on care costs regardless of what they pay per week of care. This is the main reason so many councils are facing bankruptcy (with a few exceptions where there’s been serious financial mismanagement). It seems to me that most tax payers are going to see far worse public services, all so that some older adults can pass on more inheritance at the end of their lives. They’re not going to spend much on themselves once they’re dependant in care, so I find it unbelievable that the ‘injustice’ of paying more than a local authority (who are a bulk purchaser) for a care package is being used to justify driving councils to bankruptcy and decimating services for everyone else. Do people not realise this is happening, or do people just care more about their inheritance than they do about schools, rubbish collection, roads, child protection, public health..?

OP posts:
grottyb · 03/11/2023 16:53

Why should those who have been frugal pay the cost for the feckless who never saved a penny?

This is such a redundant argument. Why should I pay high tax because someone hasn’t saved enough for pension, or abuses their body & drains the NHS? Why should I pay high tax whilst others get child benefit etc. Brandishing everyone feckless is stupid & we either have a safety net or we don’t.

ilovesooty · 03/11/2023 16:55

@grottyb West Yorkshire.

FloweryName · 03/11/2023 16:55

OP, do you think it’s fair that people who have paid their taxes and their own housing costs throughout their lives end up subsidising the care of others who haven’t done those things when they get to needing care in their old age?

Ive read people on here in similar discussions say that paying privately gives people more choice over their care homes which it does in many cases, but often they are still using exactly the same homes as council funded residents who aren’t paying anything. It is not fair that some people have to pay for the and some people don’t when they’re both living in the same place with the same facilities. I have more sympathy for those people than I do for councils.

grottyb · 03/11/2023 17:01

@FloweryName
OP, do you think it’s fair that people who have paid their taxes and their own housing costs throughout their lives end up subsidising the care of others who haven’t done those things when they get to needing care in their old age?

You can use this argument about everything though. What about all the people who don’t have dc but subsidise those that do?

wormshuffled · 03/11/2023 17:09

fetchacloth · 03/11/2023 16:29

I've often wondered whether local councils should have, and run, their own senior care facilities. These would be financed on a not-for-profit basis. This then means that the taxpayer isn't funding profit making private care facilities.
I don't think it's ethical that the taxpayer is funding privately owned facilities in this way.

I agree with this, and would lump it in the same category as the government paying Housing Benefit to private landlords.
However where would people live if this was stopped ?

stayathomer · 03/11/2023 17:09

Maybe we shouldn’t be so obsessed with keeping someone alive at all costs but with a shit quality of life either because we are so scared of death.
im not sure it’s that we’re scared of death though. What constitutes a state where someone wouldn’t want to live? If you said to someone if I have x wrong with me I want my life to end, where x is a mental as opposed to physical issue, how can anyone tell when they reach that stage that they still want to follow through with their wishes, made some time ago. Does a medical professional just follow through no matter what? My dad on his bad days (lung and brain tumour) used to say he wished he was gone, then on his good days he’d thank god he was alive and marvel over flowers and music we played him and say he was glad he could listen to us chat and enjoy just being alive

GasPanic · 03/11/2023 17:10

Spot on. We need to charge older people more for their care.

Because the only alternative to that is to charge younger people more for their care or cut other services to the bone.

We need to get rid of the injustice of things like trusts to avoid IHT and care home fees. And we need to get rid of the inequality of asset assessment for care, for example someone with a £5 million house should be charged the same as someone with £5 million in cash.

There is no magic wealth tree here. There are more old people and care for them has got to be paid for from somewhere. No political party is going to be able to magic up a pot of wealth from nowhere.

BIossomtoes · 03/11/2023 17:11

Flev · 03/11/2023 14:51

Right now Councils are paying way less than it actually costs to provide care. That's why providers are handing contracts back to local authorities - they simply cannot afford to deliver them and are at risk of going bust themselves. It's why salaries in care are so low, backlogs so high (hence impacting on the NHS) and standards so hard to keep high. It's not about saving private payers money, it's about making sure it is actually possible to deliver the services for council-funded individuals.

This. My local authority capped the amount it would pay for residential care at £350 a week a few years ago. My mum’s care home was billing her just shy of £1k a week at that point. People relying on the council to pay their fees weren’t getting placements at all because care providers could fill all their beds with self funders.

anniegun · 03/11/2023 17:19

I think you have this completley wrong. Its just a ruling that stops private care providers exploiting either LA's or paying customers . Neither should subsidise the other, the same rates for the same care should apply

anniegun · 03/11/2023 17:22

The biggest issue is that the Tories have failed to deliver their promised to fix social care, in fact they even bothered trying. The government would prefer to hand more money to the wealthy by scrapping IHT than invest in decent social care

cptartapp · 03/11/2023 17:22

Lots of things don't make sense or seem fair.
PIL who have hundreds of thousands in the bank and have been told repeatedly by their IFA to get rid of some money, have just been awarded over £400 a month non means tested attendance allowance which they won't spend so end up on the floor and in and out of A&E like a revolving door.
They 'means tested' my child benefit and removed it a few years ago easily enough.
We all know the funding rules for care. If we don't want to risk subsidising the next person we can spend it or drip feed it away to family over the years. And if we choose not to, that's the gamble.

BrimfulOfMash · 03/11/2023 17:33

Things cost what they cost: the gvt and councils need to be honest about the budgets they need.

How was it ever acceptable to raise the fees of self funders to subsidise LA funded?

I know plenty of people who used all their house sale proceeds on care, it ran out and they had to transfer to LA funded places. Why should they have to do that earlier to privately subsidise others?

VerityUnreasonble · 03/11/2023 17:34

People should spend their money, rather than just pile it up like a dragons gold.

Spending is good for the economy, it creates jobs, puts money in through VAT / PAYE etc.

I'd strongly encourage people to spend their money on living a good life and doing things they enjoy. Especially at pension age where you tend to be more secure in your finances. Keeping a small emergency fund is important, but blow the rest on whatever brings you joy. Having 100ks sitting in savings + 100ks more locked away in property isn't doing much for anyone.

If you eventually need care and have spent up and need subsidising that seems fair for putting that cash back into spending. You do need to get the spending done before you can reasonably predict you need care though.

fetchacloth · 03/11/2023 17:49

OhmygodDont · 03/11/2023 16:37

The thing is aswell is why is care so expensive. I get different needs need different things but I just can’t work out how it can cost 1k or more a week for a care home place. I’d want a constant 1-1 and gourmet meals tbh and people in care homes certainly any getting that level of care.

Yes, I've often wondered that too.🤔
I totally get it for someone that might need a high level of supervision, for example a dementia patient, but otherwise why on earth does it cost so much?
I can only surmise that it's a combination of shortfall of funding from councils and profit taking from the proprietor.
I really do think the whole market needs a shake up.

fetchacloth · 03/11/2023 17:55

grottyb · 03/11/2023 16:53

Why should those who have been frugal pay the cost for the feckless who never saved a penny?

This is such a redundant argument. Why should I pay high tax because someone hasn’t saved enough for pension, or abuses their body & drains the NHS? Why should I pay high tax whilst others get child benefit etc. Brandishing everyone feckless is stupid & we either have a safety net or we don’t.

Quite - and that safety net is basically the Social Contract we sign up to when we accept our National Insurance numbers.

Fifteenth · 03/11/2023 18:00

fetchacloth · 03/11/2023 17:49

Yes, I've often wondered that too.🤔
I totally get it for someone that might need a high level of supervision, for example a dementia patient, but otherwise why on earth does it cost so much?
I can only surmise that it's a combination of shortfall of funding from councils and profit taking from the proprietor.
I really do think the whole market needs a shake up.

It’s because Govt pays. If it didn’t then markets would have forced mechanisation and other means of cost cutting.

BIossomtoes · 03/11/2023 18:04

Fifteenth · 03/11/2023 18:00

It’s because Govt pays. If it didn’t then markets would have forced mechanisation and other means of cost cutting.

It’s not because the government pays - in most cases it doesn’t. It’s because the ratio of staff is very high and is required 24/7. It’s perfectly obvious to anyone who’s ever stepped inside a decent care home why the fees are so high.

Coshofliving · 03/11/2023 18:08

It's all a bit of a gamble at mid income levels isn't it? Are you going to make it to the finish line without getting stung for all sorts to keep you alive? If so you'll be better off "buying" your house [even though the house will go on long after you do and cost each successive purchaser more to occupy the same space so essentially the concept is bullshit] and saving. That means you'll still die but you'll die with a cash balance in credit. On the other hand if you're not going to be left with anything anyway you might as well spend as you go and have as nice a life as you can. One way or other you'll be paying tax regardless and you'll have spent 40+ years working. The only variation is people who've amassed enough to leave a substantial inheritance, and even then they themselves won't see the benefits of that. Takes a good four generations all doing the same with no mishaps/wars/catastrophic life events to feel the benefit to point of not having to worry.

sittinginacafe · 03/11/2023 18:19

@Theeyeballsinthesky is this really true: ‘The vast majority of older people never go near a care home. Out of 11 million people over 65 only aprox 500,000 go into a care home. ‘???

or is that the current care home population (a v different thing)

Theunamedcat · 03/11/2023 18:23

The quicker the pensioner burns through there money the quicker they have to foot the entire bill

Theeyeballsinthesky · 03/11/2023 18:25

It’s the current picture - out of 11 million older people over 65, currently aprox 500,000 currently reside in a care home. Regarding future care home needs, that’s predicted to rise over the next 10/20 years but equally the vast majority of people who need to go into a care home will be home owners

however its also likely that we won’t be able to meet the demand

https://www.caremanagementmatters.co.uk/feature/darting-through-the-decades-future-demand-for-older-peoples-care-homes/

Darting through the decades: Future demand for older people’s care homes

Recent research from Knight Frank shows care home operators could face cost increases of up to 30% over the coming year, what does the future for the sector look like?

https://www.caremanagementmatters.co.uk/feature/darting-through-the-decades-future-demand-for-older-peoples-care-homes/

Thebestwaytoscareatory · 03/11/2023 18:26

Yanbu, anyone with an ounce of sense could see the elderly care timebomb ticking down for decades. Yet, as they've done with pretty much everything else, the generations in power have buried their heads in the sand and are now trying to pass the responsibility on, to the detriment of younger generations generations.

The level of mismanagement, greed, ineptitude, corruption, and selfishness displayed over the last 60 years, and especially the last 40, is rage inducing.

HelpNeededBeforeIHaveABreakdown · 03/11/2023 18:28

Care for older adults IS a public service.

nonumbersinthisname · 03/11/2023 18:33

Care isn’t just care homes. Even more elderly people are supported at home with carers, because that’s cheaper than a care home. My DM has carers visit 4x a day and pays £1.3k a month for the privilege. It’s rapidly using up her savings, and she still has to pay for all the overheads of owning a house.

Because the services are contracted out and the carers aren’t employed by the council, we all pay more to ensure the caring company make a profit while the hard working careers get minimum wage. “The market will find a solution” has been the mantra for 40+ years and is bollocks.

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