Care at Home Bill could cost £20m a year extra, council leaders warn

[Careathome]

Some local authorities could be hit by extra care costs of more than £20 million a year because of the Personal Care at Home Bill, council leaders say.

Authorities in areas with large numbers of residents who currently pay for care, but who will want to take up the Government’s free care pledge, may be forced to make cuts to services.

The more affluent Home Counties are widely expected to be worst affected because they currently have the highest number of “self-funders” who will want to apply for free care. Henry Smith, chairman of South East Strategic Leaders (SESL), a local authority collective covering nine million residents in counties from Oxfordshire to Essex, said that the extra annual personal care costs in their area could amount to at least £100 million.

“We think the principle is worthy, but the concern is how it’s going to be paid for,” said Mr Smith, the leader of West Sussex County Council. “I expect the Department of Health is pretty concerned as well. This was an announcement by the Prime Minister and now Whitehall and local government are desperately trying to work out how it can be funded.”

The Government has calculated that 270,000 people with “critical needs” will take advantage of full free care, with a further 130,000 receiving “re-ablement” — such as adaptations to their homes and training in self-care.

Of the full claimants, 166,000 already get means-tested care free as part of their benefits, leaving just over 100,000 who will be new recipients of free care, the Government predicts. These must include all applicants who currently pay for their own care or make a contribution or receive informal care. It would also include those who may return to their own homes from a nursing home, or who have unmet needs.

Mr Smith said that concerns about who would be eligible, and how they would be assessed, were equally worrying. At present, assessment falls to local authorities, who will need to find extra staff to vet applicants. Any person who requires significant help with four key daily tasks — washing, dressing, eating or using the lavatory — would qualify under the proposals.

The £100 million cost is based on estimates by all SESL members. Kent County Council said that it thought free personal care would cost between £9 million and £22 million a year if government support was maintained beyond 2011. Without this, it believes the bill would increase to £34 million — the equivalent of 5 per cent on council tax bills.

Research by the Association of Directors of Adult Social Services across 61 councils indicated the cost would be more than £1 billion — not the £670 million suggested by ministers.

In Scotland, which introduced free personal care in 2003, annual costs had more than doubled by 2008, far above initial estimates. The number of claimants went up by more than a third over the same period. Research by the University of Strathclyde shows that over the same period, lesser needs services — such as cleaning and help with groceries — had dropped by 24 per cent, despite the growing number of elderly people.

Mr Smith said that the number of signatories to a letter to The Times — the largest addition so far to growing criticism of the measure — had come as no surprise. He said that his member councils were resigned to the possibility that other frontline services would be affected.

Of the 78 who signed, three quarters were on Conservative-led councils, with 14 Liberal Democrats and five Labour, although three of these asked yesterday evening for their names to be removed.

Full article Times Online Sam Lister, Health Editor