John Hayward Posted: 30 March 2010
Keywords: Health,
Adult care in England is currently means-tested but the Government wants to introduce a compulsory levy to create a universal system of social care and has pledged to pay the costs of residential care after two years.
We hear a lot of warnings about the social and economic implications of an ageing population, but it's actually surprisingly difficult to obtain hard figures on the current situation. Perhaps contrary to the impression that is often given, around 2.5 million older people in England have care needs, but less than one million of these are considered to have high levels of need (meaning that they will have difficulties with three or more activities of daily living, such as getting dressed or getting around). Most people, with support, are able to continue living independently at home, with the result that just 208,530 people aged 65 and above (2.1 per cent) were living in care homes in 2009.(1) Of that number, the majority are over 85 and female, 45 per cent enter as a consequence of mental health issues, and more than half of all admissions to care homes come from hospital referrals.(2)
That said, two in every three women, and one in every two men, can apparently expect to have a high care need at some point during their retirement and one in five people needs residential care for an average of two years at the end of their lives.(3) Yet, a pledge to pay the costs of residential care after two years will therefore mean nothing to nine out of ten pensioners.
As with all social issues, the question of caring for older people with high care needs is more than simply a financial one, yet this often appears to be overlooked in policy discussions. For a number of months we have been updating our 1990 report From Generation to Generation, looking at the role and care of older people, and our emphasis is very much on the personal dimension of growing older.
Many cultures around the world show the greatest of respect to the elderly, prizing virtues such as wisdom and experience. Not so the West, with its air-brushed images of perpetual youth and demand for people to be 'productive'. The 2001 Census established that 12 per cent of the adult population provide unpaid care of some sort, with over a million people providing more than 50 hours of care per week. While this is often portrayed as a negative thing, many other countries see care for the elderly as a partnership between the government, the community and the family and would encourage such local care: for instance, Singapore's 1995 Maintenance of Parents Act places a legal obligation on children to pay for their parents' care.
As our nation continues to reflect on how best to provide for those with social care needs, this less individualistic attitude reminds me of a quotation from the former Dutch Prime Minister Abraham Kuyper: 'The holy art of "giving for Jesus' sake" ought to be much more strongly developed among us Christians. Never forget that all state relief for the poor is a blot on the honour of your Saviour.' Perhaps we should be looking to the Church, not the State, to help us provide for our families and neighbours?
It's interesting (particularly in the light of other posts on this blog, for example Understanding the iWorld) that adult social care is so closely linked to the cross-party personalisation agenda in public service delivery http://bit.ly/3ZFGmM
Dal Warburton 30 March 2010
Perhaps, before we adopt the right-wing views of Abraham Kuyper, and discount state "interference" in care provision, we should remember that the demands imposed by the market economy in terms of long hours, workforce mobility and career expectation have contributed to the fragmentation of society that in turn generates the need for state provision of care services. Perhaps state provision is simply an admission of corporate responsibility for the vulnerable, which is a thoroughly biblical principle. After all, at its best, the state is simply all of us working together for a common purpose.
Bob Bartindale 6 April 2010
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Caregiver 30 August 2010