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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:
FloweryName · 03/11/2023 20:53

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?

No, you can’t.

Subsidising other people through general taxation is not the same as subsidising other people through paying fees to a private service provide for something you are forced into needing through the luck of your health.

WrongSwanson · 03/11/2023 21:24

FloweryName · 03/11/2023 20:53

No, you can’t.

Subsidising other people through general taxation is not the same as subsidising other people through paying fees to a private service provide for something you are forced into needing through the luck of your health.

Exactly. It's frustrating that people can't grasp the distinction

grottyb · 03/11/2023 22:08

No, you can’t.

Subsidising other people through general taxation is not the same as subsidising other people through paying fees to a private service provide for something you are forced into needing through the luck of your health.

I don’t understand this point. Taxation is used to pay for other private services eg landlords, childcare settings. Or are you saying that all people in care homes who aren’t paying for the service are being subsidised by those who do pay & there’s no other funding source?

WrongSwanson · 03/11/2023 22:24

grottyb · 03/11/2023 22:08

No, you can’t.

Subsidising other people through general taxation is not the same as subsidising other people through paying fees to a private service provide for something you are forced into needing through the luck of your health.

I don’t understand this point. Taxation is used to pay for other private services eg landlords, childcare settings. Or are you saying that all people in care homes who aren’t paying for the service are being subsidised by those who do pay & there’s no other funding source?

The issue isn't taxation paying for privately delivered services (that's a different, albeit interesting debate)

It's that Mrs Jones pays (say). £2000/week out of her own pocket while the LA pays £350 a week for Mrs Smith for precisely the same care from the Same provider. The providers freely admit they charge much more to Mrs Jones then the service costs, so that they can afford to accept some LA placements.

So Mrs Jones isn't just paying for her own care, she is directly (not through general taxation) paying for Mrs Smith's care.

Noone can think that is fair

WrongSwanson · 03/11/2023 22:26

Nb before anyone challenges the numbers - it's arbitrary numbers to illustrate the point

Diolchynfawr · 03/11/2023 22:27

MrsTerryPratchett · 03/11/2023 14:01

The fact is that cutting public services makes it more expensive, not less. Cut children's services, you'll clean up more graffiti. Cut child protection, you'll need more prisons and rehabs. Cut leisure, you'll have more expensive healthcare.

The real issue isn't pensioners fighting with children, it's underfunding everything.

this, and this again.

OMGitsnotgood · 03/11/2023 22:37

Not all people self funding care are as 'affluent' as others. I do think that care should be better means tested than it is. Someone with £50k in savings will pay the same as someone with £5million. That doesn't seem fair.

I'm also surprised that the same rate is being paid by councils as self funders- i am aware of homes where the council pays less than private payers

grottyb · 03/11/2023 22:41

@WrongSwanson but my understanding is funding also comes from the local authority. And tbh even if 100% of funding came from the LA I don’t think the private places would be any cheaper do you?

So Mrs Jones isn't just paying for her own care, she is directly (not through general taxation) paying for Mrs Smith's care.

And I don’t think it’s unique as I said. Childcare providers charge more for places to cover the cost of free places? Businesses build in the cost of theft, loss etc into retail prices. Wasn’t dentistry costs bought in the subsidise the cost & some groups get it free.

Nothanksthanksanyway · 03/11/2023 22:45

grottyb · 03/11/2023 19:15

The budget for children / children in care , working age adults with LD / Autism / sensory etc is much more significant.

How do you separate the figures spent on adult social care for working age vs older people?

I work in the sector and I’m pretty sure financial reports ( spends and budgets ) that are published are also split into cohorts.

BIossomtoes · 03/11/2023 22:49

OMGitsnotgood · 03/11/2023 22:37

Not all people self funding care are as 'affluent' as others. I do think that care should be better means tested than it is. Someone with £50k in savings will pay the same as someone with £5million. That doesn't seem fair.

I'm also surprised that the same rate is being paid by councils as self funders- i am aware of homes where the council pays less than private payers

No they won’t. That £50k will run out very quickly indeed. The person with £5 million will be paying until their last breath - and they’ll be in a much, much nicer care home, one that no publicly funded person will ever see the inside of. My parents’ care home only took self funders.

OMGitsnotgood · 03/11/2023 22:56

No they won’t. That £50k will run out very quickly indeed. The person with £5 million will be paying until their last breath - and they’ll be in a much, much nicer care home, one that no publicly funded person will ever see the inside of. My parents’ care home only took self funders.

I was making a point. Obviously the person with £50k will run out of money very quickly. The person with £5m in the same care home will pay the same and that was my point. They are hardly likely to live long enough to exhaust their savings . I get that they can afford better care - i was just drawing a parallel to say it seems unfair that they all pay the same in the same care home. We have a relative in a privately funded care home, chosen partly because the state will take over payment for that home when the time comes.

JenniferBooth · 03/11/2023 23:04

I see there is the usual cognitive dissonance going on here, because the ones who wont be able to fund their own care are the care workers caring for todays elderly Because their wages are too low Are you really going to begrudge them care when they are older? if they all took the advice to find a better paying job tomorrow the shit would hit the fan even sooner

WrongSwanson · 03/11/2023 23:09

JenniferBooth · 03/11/2023 23:04

I see there is the usual cognitive dissonance going on here, because the ones who wont be able to fund their own care are the care workers caring for todays elderly Because their wages are too low Are you really going to begrudge them care when they are older? if they all took the advice to find a better paying job tomorrow the shit would hit the fan even sooner

No one is begrudging them their care.

But it should be paid for by the tax payer, not by Mrs Jones in the room next door who is really poorly but just managed to scrape by and pay her mortgage her whole life

grottyb · 04/11/2023 00:12

@Nothanksthanksanyway can you link anything? When I googled council
spending it lumped all social care together.

grottyb · 04/11/2023 00:19

But it should be paid for by the tax payer, not by Mrs Jones in the room next door who is really poorly but just managed to scrape by and pay her mortgage her whole life

Why has Mrs Jones managed to scrape by? I hate the moralising on these debates. poor Mrs Jones who worked all her life to fund feckless Mrs Smith in the next room 🙄

Flopsythebunny · 04/11/2023 00:23

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.

They used to. Some still do have council run specialist dementia units

BrimfulOfMash · 04/11/2023 00:32

grottyb · 04/11/2023 00:19

But it should be paid for by the tax payer, not by Mrs Jones in the room next door who is really poorly but just managed to scrape by and pay her mortgage her whole life

Why has Mrs Jones managed to scrape by? I hate the moralising on these debates. poor Mrs Jones who worked all her life to fund feckless Mrs Smith in the next room 🙄

Er wasn’t it Mrs Smith the hard working under paid care worker who was being subsidised?

Anyway, the point is that those who cannot afford it should be supported by our state system (which has money from many sources, not just ‘the taxpayer’ ) which is democratically accountable. Not by an informal unaccountable system of private subsidy managed by privately run profit-making businesses.

DisquietintheRanks · 04/11/2023 00:35

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.

Actually it's really not that hard when you do the maths. Cost of a purpose built care home mortgage, maintenance, energy costs (high), 24 hour staffing at the correct ratios, home cooked food, running a minibus, specialist equipment (all needs regular servicing) and so on. And then, yes, subsising those funded by the local authority and profits.

WrongSwanson · 04/11/2023 00:35

grottyb · 04/11/2023 00:19

But it should be paid for by the tax payer, not by Mrs Jones in the room next door who is really poorly but just managed to scrape by and pay her mortgage her whole life

Why has Mrs Jones managed to scrape by? I hate the moralising on these debates. poor Mrs Jones who worked all her life to fund feckless Mrs Smith in the next room 🙄

Show me where I suggested Mrs Smith was feckless?

I didn't.

I may well be Mrs Smith in the future (work v hard in public service but facing disability that may mean i can't work soon,)

Mrs Smith's care should be paid for by the taxpayer.

Just not by Mrs Jones's own personal care bill.

I can't see what's hard to understand here.

grottyb · 04/11/2023 00:52

Show me where I suggested Mrs Smith was feckless?

I thought my post was clear that I was talking about the narrative of these debates & the narrative is often the ones who pay for their care were hardworking, didn’t spend recklessly etc whereas as the ones who don’t are somehow lesser.

Mrs Smith's care should be paid for by the taxpayer.

Taxpayers do pay though?

I can't see what's hard to understand here.

clearly 😆

WrongSwanson · 04/11/2023 00:57

grottyb · 04/11/2023 00:52

Show me where I suggested Mrs Smith was feckless?

I thought my post was clear that I was talking about the narrative of these debates & the narrative is often the ones who pay for their care were hardworking, didn’t spend recklessly etc whereas as the ones who don’t are somehow lesser.

Mrs Smith's care should be paid for by the taxpayer.

Taxpayers do pay though?

I can't see what's hard to understand here.

clearly 😆

"tax payers do pay"... They pay a component, the rest is subsidised by Mrs Jones and the other private residents because the LAs won't pay the full amount. This has been explained multiple times, by different people, in very plain English.

grottyb · 04/11/2023 01:18

Mrs Smith's care should be paid for by the taxpayer.

So what you meant to write was 100% of the care costs should be paid by the taxpayers… because as I said taxpayers do pay.

This has been explained multiple times, by different people, in very plain English.

The irony 😆

grottyb · 04/11/2023 01:19

Mrs Smith's care should be paid for by the taxpayer.

So what you meant to write was 100% of the care costs should be paid by the taxpayers… because as I said taxpayers do pay.

This has been explained multiple times, by different people, in very plain English.

The irony 😆

grottyb · 04/11/2023 01:20

And why is it wrong that someone who can pay does pay? I’ve not seen a coherent argument.

MrsFezziwig · 04/11/2023 01:33

grottyb · 04/11/2023 01:20

And why is it wrong that someone who can pay does pay? I’ve not seen a coherent argument.

I don’t think anyone has said that they shouldn’t pay. What they have said is that they shouldn’t be expected to pay for their own care and additionally to subsidise residents who are council-funded.

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