Social Care White Paper: Building a National Care Service – briefing for

ECDP members

This week (end of March 2010), the government1 published its Social Care White
Paper ‘Building the National Care Service’. This sets out the government’s plans
to create a National Care Service for all adults in England.

The purpose of this briefing is to update ECDP members and other interested
people on:
1. The background and context of the Social Care White Paper
2. Overall summary of the White Paper’s aims
3. The key elements of the White Paper
4. What this could mean for disabled and older people
5. How this will be funded
6. What other people have said about the White Paper
7. How you can find out more

If you have any questions about this briefing, please contact Rich Watts
(rwatts@ecdp.org.uk).

1. The background and context of the Social Care White Paper

The White Paper has been published as a result of government recognition that,
if left unchanged, England’s social care system is not equipped to care for the
next generation. Over the next 20 years, it is anticipated an additional 1.7 million
people in England will have a care and support need, given increasing numbers
of disabled people and longer life expectancy.

In July 2009, the government published its Social Care Green Paper, which
originally proposed the idea of a National Care Service, and which called for a
‘Big Care Debate’ to discuss what this National Care Service might look like and
how it would be funded.

(ECDP’s briefing on the Social Care Green Paper is available here:

http://www.ecdp.org.uk/home/2009/7/17/briefing-on-the-social-care-green-
paper.html.)

The views of thousands of stakeholders were taken in to account during ‘the Big
Care Debate’, through various engagement processes, including consultations
on the Green Paper proposals. ECDP was just one of many organisations which
consulted its members on this – we ran a focus group on the government’s
proposals at our AGM in November 2009.

1
Please note: ECDP does not support any political party. This briefing provides a
summary of the White Paper proposals for our members, and presents (in
section 6) the known position of the other main political parties.

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You can find our response to the government’s consultation on our website here:
http://www.ecdp.org.uk/home/2009/11/7/ecdp-contributes-to-the-big-care-
debate.html.

2. Overall summary of the White Paper’s aims

The key aim of the White Paper is to introduce a National Care Service, based
loosely on the principles of the National Health Service. This would mean that
care and support would be offered to any English citizen whenever they needed
it.

The underpinning principles – of a free, accessible, supportive, universal care

and support system, run by local authorities working in partnership with other
organisations such as the NHS, to give users choice and control – are designed
to make that service a reality.

3. The key elements of the White Paper

Given the complexity of the issues associated with care and support in England,
the White Paper proposes a 3-stage approach to implementing its
recommendations. These are outlined below.

All of these stages are likely to be dependent on the result of the General
Election (which is being held on 6 May 2010).

Stage One: 2010

• Implementation of the ‘Personal Care at Home Bill’, which aims to provide

free care in the homes of people with the highest needs from 2011 (costing
£670 million a year)
• The government is also aiming to have re-enablement services in every
community to support people regaining their independence when they need
care at home for the first time
• Seeing through existing reforms, which include: the Carers Strategy, the
Dementia Strategy, the Autism Strategy, the Right to Control, and ‘Putting
People First’ – the government’s commitment to the transformation of adult
social care. Existing reforms also include the government’s 3-year strategy for
people with learning disabilities, Valuing People Now.

Stage Two: 2010- 2015

• A cross-party Commission will be set up at the start of the next Parliament to

investigate the best way to fund the National Care Service
• At the same time, stage two will entail building the systems and processes
necessary to implement the National Care Service, including setting up the
National Care Service Leadership group by July 2010. This group will support

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 delivery of the National Care Service and provide an implementation plan by
the end of 2010
• In the next Parliament (i.e. after the General Election), a National Care
Service Bill will be introduced to set out the duties of the Secretary of State
and local authorities
• From 2014, care entitlements will be extended to provide free residential care
to anyone who has been using the service for more than two years (this does
not include accommodation costs). This will cost £800 million a year.

Stage Three: 2015 onwards

• This is the final stage, where the National Care Service comes into existence.
This will happen after the next general election but one (i.e. probably 2015)
and will cost an estimated £4.4billion.

4. What this could mean for disabled and older people

These plans would mean a radical overhaul of the current system. However, the
government has stressed that the changes will be introduced in stages, as
described above. Furthermore, much of the plans will also depend on the results
of the next General Election.

Should Labour be re-elected, these plans will still take a series of years to
implement. If the next government is a Conservative led one, the plans will take a
different shape.

Irrespective of which political party forms the next national government, the plans
will still depend on local councils putting them in place.

Thus, the immediate impact on disabled and older people is relatively unknown.

5. How this will be funded

Currently, care – both residential and that provided to people in their own home –
is usually only provided by the state when the individual has a low income and
therefore cannot pay for themselves. Qualifying for different types of care or
support is often further dependent on your local council.

A number of funding models were considered and debated in the Big Care
Debate.

The final option chosen in the White Paper is the ‘Comprehensive’ Scheme.
Under this model, the government would make a contribution to the costs of care
for everyone eligible to receive it. On top of this, all people over 65 who could
afford it would be required to pay in to a central pot, and anyone who needed
care would then have their care paid for from this central pot. Original estimates

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were that this would reduce premiums to about £17,000 – £20,000 per person,
but that people would need to pay regardless of whether they needed care or
not.

At present, it is not known if this will actually be the funding model used for the
National Care System. Because it is such a complex and controversial area, the
government will set up a cross-party Commission to examine the best ways for
the National Care Service to be funded.

The government’s original proposals for funding created a lot of controversy

around how Disability Living Allowance or Attendance Allowance may be used to
pay for the plans. According to the White Paper, there will not be any changes to
Disability Living Allowance or Attendance Allowance before 2015. However, the
Commission on funding will discuss alterations after this time.

It has also been estimated that £100m may be cut from Attendance Allowance.
The government has justified this by stating that some people who receive
Attendance Allowance in the current system will qualify for free residential care
under the new system so would no longer require this benefit, therefore saving
money.

6. What other people have said about the White Paper

In their manifesto, the Conservatives reject Labour’s plans for health care,
instead proposing that individuals in need of care pay a voluntary contribution of
£8,000, which would waive their care costs. People would be given the option of
topping up this premium to receive care in their own home.

The Liberal Democrats’ manifesto proposes to integrate health and social care to
create a dial service, with the view to assisting people to stay in their homes for
longer. They state that they would use the money Labour is currently using for
the Personal Care At Home Bill to provide guaranteed respite care for carers.
The Liberal Democrats say they would establish an independent commission,
with cross-party support, to develop proposals for long-term care of the elderly.

Outside the field of politics, many key personnel have added their thoughts on
the White Paper.

Jenny Owen, president, Association of Directors of Adult Social Services said:

There can be no doubting the proposals’ far-reaching ambition, nor the

difference they would make, if fully achieved, to the quality of life of
hundreds of thousands of people. There are no guarantees that this White
Paper will see the light of legislative day, nor that the principles and
objectives it embraces will be achieved in the timescale set.

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Anna Dixon, acting Chief Executive of the Kings Fund said:

We welcome a staged approach but this will only work if detailed

proposals are set out without delay. While political consensus is vital
further deliberation could slow down the momentum for reform. We will
face increasing demographic need. Whoever wins the next election must
ensure that reform begins as soon as possible.

Emma Stone, co-director policy and research, Joseph Rowntree Foundation

said:

The White Paper proposals set out a clear vision for a national service and
funding system that has the potential to meet these criteria, and this must
be commended. Much work needs to be done in the next parliament about
exactly how people will pay for this system. Ideas allowing each
generation to pay for the costs of its own care in later life are already on
the table.

Amanda Redmond from Carers UK said:

This White Paper places carers at the centre of social care - recognising
that a new National Care Service will not take care away from families, but
would support them.

7. Where to find out more

To visit the government’s website on all its work on social care, follow this link:
http://careandsupport.direct.gov.uk/

To read the White Paper in full, follow the link below:

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digita
lasset/dh_114923.pdf

For other formats, including easy read or larger print, follow the link below:
http://careandsupport.direct.gov.uk/the-white-paper-and-supporting-documents/

The manifestos of the three main parties are available here:

• Conservatives: http://www.conservatives.com/Policy/Manifesto.aspx
• Labour: http://www.conservatives.com/Policy/Manifesto.aspx
• Liberal Democrats: http://www.libdems.org.uk/our_manifesto.aspx

ECDP’s briefing on the Social Care Green Paper is available here:

http://www.ecdp.org.uk/home/2009/7/17/briefing-on-the-social-care-green-
paper.html.

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Our response to the Big Care Debate is available here:
http://www.ecdp.org.uk/home/2009/11/7/ecdp-contributes-to-the-big-care-
debate.html.

About ECDP

We are an organisation run by and for disabled people. Established in 1995 our
origins are firmly rooted in a belief that the voice of disabled people, both as
individuals and collectively, is vital if the lives of disabled people are to be
enhanced.

Our vision is to enhance the everyday lives of disabled people in Essex and
beyond.

We currently provide a wide range of support, information, advice and guidance

services. We also play a key role in influencing the agenda of tomorrow to effect
real social change to enhance the everyday lives of disabled people.

Our work for the next four years is captured in our Strategic Plan 2008-12, which
contains our vision, mission and values, as well as our strategic aims and
objectives.

We are a registered Charity number 1091293 and a Company Limited by

Guarantee number 4217686.

For more information about who we are and what we do visit our website:
www.ecdp.org.uk.

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