THE DEBATES HELD over the past week, as the proposal to provide free care for older people with the highest needs passed through the first stages of the House of Lords process, have been both illuminating and complex. But they have been squabbles over a relatively small amount of money in contrast to the very large sums that would have to be raised if the objectives of the government’s Green Paper are ever to be met. That isn’t to say that we shouldn’t point out the implications for local authority adult social services having to find an additional £330 millions the government didn’t talk about on top of the additional £250 millions that they did! But it is also to try to remind ourselves that there is a bigger picture here, that the Green Paper did address that bigger picture, and that the White Paper due out by Easter is a further opportunity to study it in greater detail. We fully support policies that enable people to stay at home when they have critical care and support needs. And we are well aware that this is what older and disabled people, and their families and carers, want. We are also well aware that some people incur considerable costs when paying for their long term care, and find it very difficult and confusing to understand when it is free - for example because they are eligible for continuing health care - and when they have to pay. The Personal Care at Home Bill by focusing on only one aspect of the funding of adult social care threatens to lead to concerns being shown by those people who will still have to pay for their social care in the future. These include people who have a fractionally lower level of need but still require considerable support, as well as those receiving residential and nursing care. Local authorities having to find any efficiency savings to pay for this has raised concerns. There is an established protocol that any new additional burden created by the Government will be funded in full by the Government. This appears to be a breach of that protocol. In addition, it is important to note that most local authorities are committed already to delivering four per cent efficiency savings to work within the limited resources available and to meet the cost pressures they face – most notably the costs of increasing numbers of older people and adults with disabilities who need care. However, the even bigger issue arises as local authorities are coming to the view that the cost of implementing this policy will be significantly more than the figure estimated by the Government. Calculating the costs isn’t straightforward. They comprise four elements: * The loss of income from those currently paying for their care, * The costs of providing care to those who are currently arranging their own care, or paying for residential care or who are doing without care because they don't want to pay for that care, * The costs of offering re-ablement to all those with the highest levels of need,The costs of assessing new people who come forward or reviewing the circumstances of all those receiving care currently and paying for that care. Our survey estimated that the cost of implementing this policy is a minimum of £1 billion in contrast to the Government's estimate of £670m. The most significant element is the cost of providing care to those not currently known to social services. A total cost of £1 billion is approximately 50 per cent more than the Government estimates. However, the implications for local authorities are much greater even than this. The Government has made it clear that the maximum it will fund is £420m. This means that local authorities would have to find £580m instead of £250m - in other words they would have to find two and one third as much as suggested by the Government. It is, of course vitally important that if the Bill goes through, free care for older people in the highest bands of need is seen to be fair, and affordable, and to leave no doubt in the public mind when a person is eligible for free care, and when they are not. But this is the tip of a series of issues concerning the way we care for our older citizens, and the way we pay for everyone's care - not just those few thousand who might qualify for free care. This is why we are urging Government to focus on the White Paper on the Future of Care and Support, following the wide consensus that has emerged from the big Care Debate over the last six months. There is complete agreement that there is a need for comprehensive reform of the social care system and a new funding system to make it sustainable in the future. In the promised White Paper the Government will be wrestling with a variety of options, all of which require people in our society, one way or another, to contribute more money than they do now to the costs of their own and others' care needs. It is vitally important that the issues surrounding this debate are not obscured, nor in any way played down by the passions aroused by the debates over free personal care. The story at it's source http://www.adass.org.uk/index.php?option=com_content&view=category&layout=blog&id=85&Itemid=198