Despite Andy Burnham's social care reforms, family homes will still need to be sold – John McLellan
John McLellan knows first-hand about the high cost of nursing home accommodation
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Personal experience inevitably shapes opinions and, as far as care for the elderly is concerned, millions of people with individual knowledge of the system would have been nodding in agreement and sympathy with Prime Minister Andy Burnham as he outlined his vision for reform this week.
His grandmother Kitty had her engagement ring ripped from her finger by a thief in her care home, he said. “And the modest savings she had built up through her life, starting from the house where I was born? All taken to pay for it.” It was, he said, “care not worthy of the name”.
No one can argue with that, but despite a recent BBC Scotland investigation revealing appalling treatment in an Inverness home, most people with experience of care home staff, like those who looked after Mr Burnham’s late father, will testify that such behaviour is rare. The vast majority provide exemplary care with staff going above and beyond, even though too many people parked on benefits wouldn’t get out of bed for the kind of salaries on offer.
SNP’s ill-fated National Care Service plan
My mother is now in an Edinburgh care home, and on the basis that my experience is as valid as Mr Burnham’s, I’d argue it sheds as much light on the subject as his. But like every relative of someone in the Scottish care system, we have the advantage over him of knowing exactly what free care for the elderly is like.
It was not so great that the SNP didn’t want to reform it, but their botched attempt to set up a National Care Service looked like an easy way to waste £2 billion on bureaucratic empire building, and up to £35 million was reportedly squandered before the plan was abandoned.
Mr Burnham is staking his future on avoiding a similar fiasco and, in what was arguably one of the most consequential conference speeches by a Prime Minister for decades, there can be no questioning the honesty of his ambition to transform the English care system. But whether whatever system emerges will meet the expectation he has created is another thing entirely.
Of course he needs to win the next election, whenever that might be − and with borrowing soaring, it’s looking more likely that he will go all the way to 2029 – but if free care for the elderly in Scotland is the model, then a lot of people are going to be very disappointed.
He could not have been clearer that he wants a system “which gives peace of mind over care needs in later life” and “protects people’s homes and their savings”, but while the Scottish set-up does mean that visits from carers are publicly funded, for those with homes and savings, residential care is most definitely not free.
£2,000 a week
Peace of mind? I don’t think so. Scottish care homes are full of people whose houses had to go, my mum amongst them.
Only when total personal assets are down to £22,000 is accommodation free, and when an average residential care home in Edinburgh costs just under £2,000 a week − Glasgow is much cheaper, but it’s still around £1,500 a week for someone with dementia − the equity from a house sale quickly vanishes. We’ll be in that position sometime next year and who knows what happens next.
By Wednesday morning, Mr Burnham was having to clarify that he was not including residential care, which means that if you are unlucky enough to become a dementia victim, you will almost certainly end up in a care home and your money will start to go.
According to information from the National Institute for Health and Care Excellence in March this year, that’s six per cent of people aged 75 to 79, rising to just over 11 per cent of those aged 80 to 84, and if you make it into your 90s your chances of going ga-ga are almost one in three.
Average savings are around £16,000, but when other assets, pensions and property are included, analysis of National Statistics suggest average total wealth could be as high as £500K, which means the average person will need to self-fund any residential care needs they may have.
Therefore, even if Mr Burnham is able to abolish the triple lock on pensions to generate £15 billion to help fund free personal care, it will do nothing to cushion the impact of residential care costs on the average person. Savings will still need to be raided and homes will still need to be sold.
Scotland’s Barnett formula boost
It is true that making care free at the point of need does make a difference, and for those able to stay in their own homes the benefit is noticeable, but it has only been possible in Scotland because of the generosity of the Barnett formula which provides for higher public spending than in England.
The carers who visited my mum at home were on the whole excellent, but infections became increasingly frequent which indicated the care from time-pressured staff without medical expertise may have been less than adequate. And when the bugs kicked in, the limitations became clear; as her mobility deteriorated they simply called for an ambulance to take her to hospital for something which would not normally need an admission.
Let’s just say that, on her last stay with Gartnavel’s geriatric ward, we wouldn’t have needed to burn through the equity from the sale of her flat if we hadn’t got her out and into a nursing home where the care is exemplary. She has not been near a hospital for nearly two years, but it costs.
Pension reform will cost Mr Burnham too, and English taxpayers even more. But family homes will still need to be sold.
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