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Free personal care would be fairer and cut NHS pressures

Proposals to cap care costs would leave most older people still at risk of ‘catastrophic costs’

Louise Prime

Thursday, 25 April 2019

Free personal care is a fairer, more transparent system that is affordable, would benefit far more older people than the current system does, and can eliminate “catastrophic costs” for all older people receiving care – as well as reducing pressures on the NHS – according to Independent Age. The charity reported* that various proposals to cap the costs of care would leave the majority of older people still at risk of “catastrophic costs”, while costing not much less than free personal care.

New research that it commissioned, conducted by YouGov, revealed that more than half of older adults who own their homes, fear losing their homes as well as their savings to pay for their own future care costs. The survey showed that 58% of English adults and 56% of homeowners aged 50 and over worry about this, but fewer than a quarter (22%) are saving for their future care needs. Women homeowners aged 50 and over were more concerned about losing their home than men (62% v 50%); and overall, people in the Midlands were the most concerned (61%).


The charity warned that currently, more than 143,000 older people – more than a third of the 421,000 currently in residential care – are likely to face “catastrophic costs” of at least £100,000 to pay for their care.

It argued that although the government has proposed introducing a cap on costs, this would not prevent that from happening. It pointed out that separate research that it commissioned, by Grant Thornton UK LLP, revealed that a cap would fail to help the majority of older people in care homes because:

  • If the cap is set at too high a level, many older people in residential care will not live long enough to reach it – the average length of stay in a care home is 22 months.
  • Most of the proposed caps take no account of hotel costs – food, lodging and other non-care related costs - and therefore leave many older people at risk of catastrophic hotel costs.
  • A cap set at £100,000 of care costs only affects 5% of people and is only relevant after 8.5 years in care. A £72,000 cap on care costs only affects 12% of people and is only relevant after 6.1 years in care. A cap of £35,000 on care costs only affects 36% of people and is only relevant after three years in care.
  • Even a £100,000 cap that includes both care and hotel costs only affects 34% of people in residential care and is only relevant after 3.1 years in care.

The charity is urging the government to scrap the idea of a cap and instead introduce free personal care for older people – as is already the case in Scotland. It claimed that this “would virtually eliminate catastrophic costs and give every older person the right to free personal care”. It said the benefits of this approach would include:

  • reduced cost of care to individuals, families and demand for high cost residential care
  • significant reduction in unmet care needs
  • supporting more people to be cared for in their own home
  • reducing pressures on the NHS
  • providing much needed support to family carers

Independent Age’s director of policy and influencing, George McNamara, commented: “If the government is serious about protecting older people from having to sell their homes or lose their hard-earned savings then it’s time for them to scrap the idea of a cap.

“Catastrophic costs may not be a term used by many older people, but we know that many have an ever-present fear of losing their life savings or homes to pay for their care. The government has a duty and responsibility to act. 

“Free personal care, in contrast to the proposed caps, will end the worry of losing everything to fund care.  It’s simple, fair and affordable and is the reform that the majority of people want to see.”


*Bushnell J, Mitchell R and Seymour C. Free personal care: how to eliminate catastrophic costs. Independent Age, 24 April 2019.

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