Local councils provide home help services and assess who they will fund
The government is attempting to end the “postcode lottery” over care for elderly and disabled people in England.
Under new draft rules all councils in England would have to fund services for those judged to have “substantial” needs, from 2015.
Charities say that threshold is too high and would exclude many people who need help with everyday tasks.
And councils say they want assurances that any extra costs incurred will be fully funded.
Local authorities run social care services, such as home help with washing, eating and dressing or residential care, and decide who they will provide them to and whether they will pay for them.
Councils can assess people as having “critical”, “substantial”, “moderate” or “low” needs. Only four councils provide care for people in all four categories – 16 councils fund those with “moderate” needs while most, 130, only fund those with “substantial” or “critical” needs.
Three councils only fund those with in highest category.
The government says a national minimum would stop councils reducing services due to budget cuts and would level out variations between local authorities.
Mr Lamb said the draft regulations, which are being published for discussion ahead of a formal consultation next year, would set the minimum threshold at “substantial” – the level at which most councils currently operate. That would be a “starting point for local councils to base their care provision on”.
Under the draft regulations, adults who are unable to carry out basic personal and household tasks without putting themselves at risk are among those who would be eligible for funded care.
But Age UK’s Michelle Mitchell said it would effectively set the minimum level too high and exclude hundreds of thousands of elderly people with moderate needs. She welcomed the move to introduce national criteria – but said the minimum level should be set at those with “moderate” needs.
“Although this may sound like a technicality the final decision about these criteria is crucial.
“As it stands millions of older people and their families who have assumed they will benefit from the government’s social care reforms will miss out. But there is still time for the government to change their minds and Age UK will be campaigning to persuade them to do so.”
Richard Hawkes, head of the disability charity Scope, said the aim of ending the “postcode lottery” was welcome but added: “Under the proposals more than a hundred thousand disabled people who need care to get up, get washed and dressed and get out would be shut out of the system. “
Mr Lamb told the BBC councils would still be required to provide broader preventative services for those with moderate needs and to give practical guidance and support to everyone who was assessed.
He said there would be a system of appeal for those denied social care if they believed they should be eligible. And he said assessments would be “broadly similar to what has happened in the past, but it will be this national basis so that local authorities won’t be able to work out their own way of doing it”.
“Beyond that, we’re also starting work on trying to make these assessments more sophisticated to try to find ways of providing help earlier to stop your condition deteriorating,” he added.
Councils currently spend about £16bn on social care but have had to trim the amount they spend in recent years because of spending cuts.
In the Spending Review this week, George Osborne announced plans to put more money from the NHS budget into social care provided by local authorities to stop people falling “between the cracks” in the two services.
A spokesman for the Local Government Association, which represents councils, said most councils had to prioritise those in the greatest need or “risk going bankrupt” – owing to rising demand and “chronic underfunding”.
“There’s no point providing clarity over who is eligible for care if the money isn’t in the system to then provide appropriate, effective and responsive services,” he said.
He said councils needed assurances that the government’s definition of “substantial” care needs would be “equivalent to the current level outlined by councils, and that any additional costs of implementing the new system will be fully funded”.