The Dilnot report on the future funding of social care unveiled this week is the third attempt in recent years to create a fair and affordable future for older and disabled people who may need personal care and practical assistance. The Dilnot proposals are for a shared financial responsibility between the individual and the state. It is suggested that most people, following a financial assessment, would have to meet around the first £35,000 of their care costs, with public funds then picking up any continuing bills. For older and disabled people in residential care and nursing homes, this means that they would pay for about the first one and a half years of their care.
The Dilnot report recommends that there be a system of voluntary insurance to cover care costs for which people would be personally responsible. Putting aside all the exclusions that exist within private health insurance, the history here is not reassuring. Just think back to the mis-selling by the finance industry of private personal pensions, endowment mortgages and mortgage insurance policies. All of them promised security for the future, but left people stranded at the point of vulnerability and need. Of course, those who set up these schemes did very well, with big payments to their boards, senior executives and shareholders. It was those who paid into the companies, often for 20 years and more, who found that their returns were pitiable, and in some instances valueless.
Private equity and venture capital companies are hovering to make a killing off the Dilnot proposals. How do I know? While I was commenting for the media about Southern Cross and how its flawed business model has left older people in its care homes and their families anxious and insecure, I was contacted by a journalist writing for a European private equity magazine. He wanted a briefing about the potential opportunities from the Dilnot report for the international private equity and venture capital market.
We should not be surprised when in 10 and 20 years' time the encouragement to pay into these schemes, no doubt poorly regulated on the basis that the market regulates itself, has generated windfalls for rich investors, but anxiety and angst for those of us who need the care for which we thought we had been paying in advance.
It does not, of course, have to be like this. We could have care when needed funded by general taxation. This would really share the risks and costs, and it would share it fairly. At all the consultation meetings I attended when the previous Wanless report proposals were being considered, this was what many people wanted. It is not, despite the political and rightwing press rhetoric, unaffordable. After all, the government found money very quickly to bail out the banks and bankers in one year at about 40 times the year-on-year care costs that will build up over the next 20 years. There could also be a system of earmarked national insurance to meet the costs of future care needs.
Instead, the money movers who got us into the current sorry financial mess seem to be about to be given the opportunity to do it all over again.
• Ray Jones is professor of social work at Kingston University and St George's, University of London, and was formerly director of social services in Wiltshire.
