We need to change the system for paying for care in Wales - have your say
The consultation has now closed
Background
- What is "care"?
- Who needs care in Wales?
- Who provides care in Wales?
- Who currently pays for care in Wales?
- What is the system for paying for care?
- Why do we need a new system for paying for care?
- What is the Assembly Government already doing?
- What should the new system for paying for care do?
- How will the new system fit with plans for England?
- How do other countries provide care and support?
- Why does the Assembly Government want a debate about a new system for paying for care?
- How will my comments be used?
- Do you, or does a member of your family, need care or health services?
What is "care"?
When we talk about “care”, we’re describing services and other activities that help people to live independent, active and healthy lives, and to be part of the community. A lot of these care services help older or disabled people. They help people do day-to-day things like:
- Live in their home
- Work
- Cook
- Shop
- Care for their family
Here are some examples of what we mean by care services:
- Meals on wheels – having meals delivered to you at home.
- Home adaptations – such as ramps, grab rails or stair lifts.
- Housing support services – such as wardens and alarms in sheltered accommodation.
- Benefits for disabled people – extra money to help with increased living costs associated with being disabled.
- Occupational therapy – treatment to help people to overcome the effects of disability and to lead full and independent lives.
- Day care – centres in the community that provide help and support with basic tasks of daily living.
- Care homes – a residential home providing care.
- Support for carers – such as respite care, support to access social, leisure and education activities and information.
Who needs care in Wales?
Any one of us may need care and support at some point in our lives. People who use care and support services in Wales are likely to be:
- people who’ve had an accident;
- people who’ve got long term illness;
- disabled people; or
- older people.
At the moment, around 27,000 people are in residential and nursing care in Wales, and 41,000 people are receiving care services at home or day care services.
Who provides care in Wales?
People get care and support from a number of sources, including:
- their family – who often pay for care services and provide care themselves;
- their friends;
- local authorities – which pay for, and provide, services;
- central government - which provides financial help through benefits and grants;
- charities – such as voluntary and community organisations; and
- care and support businesses.
Who currently pays for care in Wales?
There are currently three sources funding the care system in Wales:
- individuals pay some or all of the costs for the services that they receive;
- families provide care, and/or pay towards the cost of services; and
- everyone in society pays through local and general taxation. The money that is raised is used to provide services or financial help.
The Government believes that the cost of care and support will always be shared, but that there are different ways that this responsibility could be balanced in the future. You can have your say about how you think this responsibility should be shared in the future.
What is the system for paying for care?
People might need care to help them be independent, active and healthy throughout their lives. If someone needs care, their care needs are assessed through an assessment that identifies what type of care they need and the ways their care will be provided.
There are different funding systems, which depend on whether the individual’s assessment shows that they need:
- continuing health care;
- nursing care;
- residential care; or
- care and support at home.
Your local authority assesses whether or not a person can pay for their care according to rules that apply for each type of care.
Why do we need a new system for paying for care?
There are two main reasons:
- we’re living much longer than we used to. Over the next 20 years, there will be more older people and disabled people in Wales who will live longer, and be in better health. Wales’ population already has a higher proportion of older people than the rest of the UK. And, although we celebrate this development, we also know that it will increase demand and pressure on the care system; and
- our expectations have changed. We will, increasingly, expect to receive high quality care and support that is tailored to our needs.
A £6 billion funding gap has been forecast at UK level, between the cost of these care services and the money that’s available to pay for them.
What is the Assembly Government already doing?
The Welsh Assembly Government has put a strategy (opens in a new window) for Social Services in place: “Fulfilled Lives, Supportive Communities”. The strategy is designed to tackle the challenges of increasing demands on social care services because of demographic and social change, and higher expectations of service quality. It emphasises that we need services that:
- actively prevent the loss of independence; and
- are efficiently delivered to the same high standards across Wales.
The Strategy aims to improve services for users through:
- improved assessment - to make sure that services focus on the people who use them;
- better leadership and senior level accountability;
- raising quality standards;
- better commissioning - so that local authorities help shape the care provision market;
- better partnerships in delivering care; and
- workforce improvements - with an emphasis on the care users, and their carers, who receive the services.
Other current initiatives include:
- The Carers Strategy for Wales Action Plan 2007 - sets out a range of measures to support carers in their caring role and help them maintain their own health. It also deals with the effects of demographic changes and trends towards more dispersed families.
- Disabled Facilities Grants and the Rapid Response Adaptations Programme - can help older people and disabled people stay in their own homes, or come home earlier from hospital or residential care, and live as independently as possible.
- The Supporting People initiative - helps vulnerable people to live independently by providing support such as advice and help with budgeting and paying bills, or help with developing cooking and cleaning skills.
- Equity release schemes - help older homeowners use their properties to access, unlock or generate income or capital sums, while continuing to live in them.
What should the new system for paying for care do?
We think that the way that we pay for care at the moment has a number of weaknesses:
- it’s complicated;
- it’s difficult to understand and follow;
- it’s inconsistent across the different care categories;
- it’s unfair to some users – such as people with Alzheimer’s disease; and
- it doesn’t encourage people to save for old age.
We want to make sure that a new system for paying for care will:
- give people independence, choice and control;
- make sure that everyone can get high quality care and that everyone gets some support from the Government, but that funding is targeted at those who need it most; and
- be affordable for the Government, individuals and families in the long term.
How will the new system fit with plans for England?
A parallel, but slightly broader consultation exercise is being done in England. It covers improvements to the delivering care and support system (which has been tackled in Wales through the “Fulfilled Lives, Supportive Communities” strategy for social services), as well as questions about paying for care.
While much of the paying for care agenda is decided by the Welsh Assembly Government, we will need to work closely with Westminster on other matters, such as benefits, as we plan the new system.
You can visit England’s consultation website at www.careandsupport.direct.gov.uk (opens in a new window).
How do other countries provide care and support?
Two interesting examples of different systems are:
- in Japan - the Government encourages people who need care and support to use formal, organised services so that family carers,
(particularly daughters and daughters-in-law), do not need to take on too much. This system is funded half by general taxation,
and half by premiums taken from the wages of people aged over 40, as well as from private pensions; and
- in Germany - the Government encourages more informal care and support. German people pay into a specific care fund throughout their working lives and people who don’t have children have to pay more. If they need care in later life, they can choose between formal services or a lower cash payment which can be used to support the family members who care for them.
Why does the Assembly Government want a debate about a new system for paying for care?
The Assembly Government believes that everyone should be able to have their say about how a new system should work, because every adult in Wales will be affected by these changes. Many of us will need care and support when we get older, or we’ll have family members or friends who’ll need it.
How will my comments be used?
We will only use your comments to shape the Assembly and UK Governments’ plans to change the system for paying for care. These plans will be set out in Green Papers for Wales and for England in 2009.
(A Green Paper is a Government’s proposal to make changes to a major policy or system that it wants to consult on. It’s usually followed by a White Paper, which is a proposal to make new legislation which would then action these changes.)
For more information, see our privacy policy.
Do you, or does a member of your family, need care or health services?
If you think that you, or a member of your family may need care services your first point of contact should be Social Services. They are part of your council and you should be able to find their contact details in your local telephone directory. Your doctor’s surgery, Citizen’s Advice Bureau or your local library should be able to help you find this information.
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