Conservative manifesto: Why many will pay more for care

Woman paying for care Image copyright ForMed Films

What the Conservatives have proposed for elderly care in England is complex.

They are changing certain thresholds as well as what can be defined as assets and how long you wait before you have to pay your bill.

But in the end it can be summed up quite easily - they want people to pay more towards the cost of their care, but are prepared to wait until you die before taking it from your estate.

Yes, some elements of their plans sound generous and certainly some people will benefit, but large numbers won't, particularly those with dementia.

Why? Because we are a nation of homeowners and these plans make sure that whatever sort of care you need, the value of your home can be taken into account.

Elderly care is not free

A quick run through the figures demonstrates this.

Unlike the NHS, social care - and that covers help with daily tasks in the home, such as washing and dressing, through to round-the-clock support in a care home or nursing home - is not free.

How much does care cost in England?

  • 1 in 4 have no or few care costs

  • 1 in 10 spend more than £100,000

  • £700 a week for residential care

  • £1,000 a week for nursing care

  • £16.70 an hour for home care

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Only the poorest receive help towards costs from their local council.

Currently anyone with assets of over £23,250 is expected to pay the full cost of their care. If you are in a care home or nursing home, the value of your house can be taken into account.

That means people with conditions such as dementia find themselves racking up significant costs. As there is no cure, they find themselves relying on the care sector rather than the NHS in a way

Why your home is key

But that is not the case if you receive care in your own home. Then, it's really only your savings and income which are taken into account.

However, the Tory manifesto promises to change that. Instead, the value of your home may be factored in, no matter where care is provided.

Nearly three times as many people get help in the community from their local councils than get a funded place in a care home or nursing home, so that change will have significant implications.

More generous or not?

The manifesto argues the plans are more generous because they raise the threshold your assets have to deplete to before you get council help from £23,250 to £100,000.

That means no matter how much your care costs, you are guaranteed to be left with that amount.

However, if you look at it the other way round, the changes seem less helpful.

Three-quarters of people over the age of 65 are homeowners and the average value of a property in England is £233,000. You don't need to be a maths genius to see that means plenty of people will become liable for more of their care costs.

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Media captionSir Andrew Dilnot tells Today that Tory social care plans "fail to tackle" the central problem

And for those with very high care needs - for one in 10 they exceed £100,000 - it means you will pay more than you would have under the £72,000 care cap that was the policy at the last election but has now been ditched.

Who falls into this group? Certainly those with conditions such as dementia are overly represented. Seven in 10 people in care homes have dementia and because there is no cure, they find themselves relying on the care system more than the NHS unlike say people with illnesses like cancer and heart disease.

So who will benefit? The Tories are not providing any modelling on numbers, but there seems to be two main groups - cash-rich non-homeowners and homeowners of low-value properties (or at least properties they don't have much equity in).

So when will people have to pay?

What the Tories are proposing is to give everyone the right to defer their care payments, which means the money will not be taken until after they die.

For those with long memories, that may sound like it has echoes of the so-called death tax - the name given to the levy Labour considered in the lead up to the 2010 general election.

But that was to help create a universal care system for all.

This plan is nothing like that. It is about asking many people to pay more of their care costs from their estate.

There are plenty of people who will say that is fair - to claw back care costs from people's estates, rather than letting them pass wealth on. But it is certainly not being sold like that.

Image copyright Design Pics

What about the extra investment?

The proposed changes to the system are being announced alongside the introduction of means-testing for the winter fuel payment. That could bring in over £1bn a year if it is restricted to those who receive pension credit.

Coupled with the extra £2bn that was announced in the Spring Budget for social care over the next three years, the Conservatives are understandably making a big play of the fact they are putting more money in.

The only problem with that is we don't know whether that will actually result in more money being spent on services.

It is up to councils to decide how much to spend on social care and as other elements of their income are being cut they may well use the extra funds for social care to offset those - unless a Tory government moves to stop that by placing new rules on town halls.

And it's not a given that you will even get any help

To benefit from the guarantee that £100,000 of your assets will be left untouched, your local council will have to assess your care needs as being severe enough to warrant help.

Just because you are frail and need some help with dressing or eating, it does not necessarily mean you will be entitled to protection even if you are paying for care.

Councils require you to have very high needs - essentially great difficulty with at least two daily tasks. About half of people with recognisable care needs fall outside of this definition, according to Age UK.

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