Figure 1 – More elderly people are reporting their health status as good or better
Figure 2 – Percentage of older people (age 65+) in long- or short-term care, from 2015-16 baseline
Figure 3 – Maximum asset depletion for an individual in residential care with total care costs of £150,000
Figure 4 – Cost of reform proposals
Figure 5 – Increasing income tax for the over-40s and means-testing winter fuel payments would shift the burden of paying for social care to older generations
Figure 6 – Higher-value properties pay less council tax relative to their value
Figure 7 – Losers from a housing services tax would be concentrated at higher income levels
- ^ Henry Zeffman, “Don’t Raise National Insurance to Pay for Social Care, Says Kwasi Kwarteng ,” The Times, July 22, 2021, https://www.thetimes.co.uk/article/keir-starmer-attacks-jobs-tax-for-social-care-jmfqqvdv9.
- ^ We discuss the means test in more detail in the following section.
- ^ OECD, Help Wanted? Providing and Paying for Long-Term Care, 2011, https://doi.org/10.1787/888932401653.
- ^ Source: Adult Social Care Activity and Finance Report, England - 2019-20, https://digital.nhs.uk/data-and-information/publications/statistical/adult-social-care-activity-and-finance-report/2019-20/appendix-b.
- ^ See Institute for Government, ‘Adult social care performance tracker, 2019’, https://www.instituteforgovernment.org.uk/publication/performance-tracker-2019/adult-social-care.
- ^ Eric Emerson and Susannah Baines, “Health Inequalities and People with Learning Disabilities in the UK,” Tizard Learning Disability Review 16, no. 1 (2011), https://doi.org/10.5042/tldr.2011.0008.
- ^ Simon Bottery and Gbemi Babalola, “Social Care 360,” The King’s Fund, 2020, https://www.kingsfund.org.uk/publications/social-care-360
- ^ Bottery and Babalola.
- ^ Source: Adult Social Care Activity and Finance Report, 2019–2020.
- ^ James Caiels, Alisoun Milne, and Julie Beadle-Brown, “Taking a Strengths-Based Approach to Social Work and Social Care: A Literature Review,” Discussion Paper, February 2021.
- ^ Source: Adult Social Care Outcomes Framework 2019–20.
- ^ Think Local Act Personal, “Direct Payments: Working or Not Working?,” 2020.
- ^ https://www.who.int/data/gho/data/indicators/indicator-details/GHO/gho-ghe-hale-healthy-life-expectancy-at-birth
- ^ See for example https://www.bbc.co.uk/news/technology-58317106
- ^ James Wright, “Technology in Social Care: Review of the UK Policy Landscape,” Sustainable Care Paper, 2020, http://circle.group.shef.ac.uk/wp-content/uploads/2020/11/2020_Hamblin_Technology-in-social-care_SC-Paper-2_Nov-20.pdf
- ^ Hugh Alderwick, Charles Tallack and Toby Watt, “What Should Be Done to Fix the Crisis in Social Care? Five Priorities for Government,” 2019, https://www.health.org.uk/sites/default/files/2019-08/20190410-What-should-be-done-to-fix-the-crisis-in-social-care.pdf
- ^ Competition and Markets Authority, “Care Homes Market Study: Final Report,” 2017, https://assets.publishing.service.gov.uk/media/5a1fdf30e5274a750b82533a/care-homes-market-study-final-report.pdf
- ^ David Bell, “Free Personal Care: What the Scottish Approach to Social Care Would Cost in England,” Health Foundation Newsletter, May 30, 2018, https://www.health.org.uk/newsletter-feature/free-personal-care-what-the-scottish-approach-to-social-care-would-cost-in
- ^ Alderwick, Tallack and Watt, “What Should Be Done to Fix the Crisis in Social Care? Five Priorities for Government.”
- ^ David Bell, Alison Bowes and Alison Dawson, “Free Personal Care in Scotland,” 2007, https://www.jrf.org.uk/sites/default/files/jrf/migrated/files/2075-scotland-care-older-people.pdf
- ^ Independent Age, “Free Personal Care: Insights from Scotland,” 2020.
- ^ Omar Idriss et al., “Social Care Funding Gap,” The Health Foundation, February 11, 2021, https://www.health.org.uk/news-and-comment/charts-and-infographics/REAL-social-care-funding-gap
- ^ Ipsos Mori, Understanding Public Attitudes to Social Care Funding Reform in England Report Prepared for the Health Foundation, 2018, http://www.ipsos-mori.com/terms.
- ^ Ben Hewitson, Becky Seale and Lucy Joyce, “Public Engagement Exploring Care and Support Funding Options,” 2011.
- ^ We would propose that the existing means test be retained alongside this proportional cap. Those with few assets would still not have to make any contribution towards their care costs, and those with slightly higher asset levels would quickly hit the cap in any event.
- ^ See Table 2.11, ONS “Total Wealth: Wealth in Great Britain”, https://www.ons.gov.uk/peoplepopulationandcommunity/personalandhouseholdfinances/incomeandwealth/datasets/totalwealthwealthingreatbritain
- ^ Peter Lilley, “Solving the Social Care Dilemma? A Responsible Solution,” 2021, https://www.civitas.org.uk/content/files/SOCIAL-CARE.pdf
- ^ Given that domiciliary care users would still need somewhere to live, the charge would be deferred until death or the sale of the property for this group.
- ^ Age UK, “Estimating Need in Older People,” 2019, https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/active-communities/id204303-estimating-needs-report.pdf
- ^ Richard Humphries et al., “Social Care for Older People: Home Truths,” 2016.
- ^ See https://www.leonardcheshire.org/sites/default/files/2019-03/social_care_briefing_-_leonard_cheshire.docx
- ^ Source: State of Care, Care Quality Commission, 2020, https://www.cqc.org.uk/publications/major-report/state-care
- ^ Source: NHS Digital, Personal Social Care Services Adult Social Care Survey.
- ^ Source: NHS Digital, Adult Social Care Outcomes Framework.
- ^ Source: https://www.health.org.uk/news-and-comment/charts-and-infographics/REAL-social-care-funding-gap
- ^ Raphael Wittenberg, Bo Hu and Ruth Hancock, “Projections of Demand and Expenditure on Adult Social Care 2015 to 2040,” PSSRU Discussion Paper, November 2018, https://www.pssru.ac.uk/publications/pub-5421/
- ^ ADASS, “ADASS Budget Survey 2019,” accessed January 13, 2021, https://www.adass.org.uk/media/7295/adass-budget-survey-report-2019_final.pdf
- ^ Source: Public Health England.
- ^ Laura Jefferson et al., “Home Care in England: Views from Commissioners and Providers,” 2018, https://www.kingsfund.org.uk/sites/default/files/2018-12/Home-care-in-England-report.pdf
- ^ Idriss et al., “Social Care Funding Gap.”
- ^ Bottery and Babalola, “Social Care 360.”
- ^ Anita Charlesworth and Toby Watt, “The Real Cost of a Fair Adult Social Care System ,” Health Foundation, 2019, https://www.health.org.uk/news-and-comment/blogs/the-real-cost-of-a-fair-adult-social-care-system
- ^ Source for all figures in this paragraph: Skills for Care, “The State of the Adult Social Care Sector and Workforce in England,” 2020, https://www.skillsforcare.org.uk/adult-social-care-workforce-data/Workforce-intelligence/publications/national-information/The-state-of-the-adult-social-care-sector-and-workforce-in-England.aspx
- ^ Skills for Care.
- ^ Marley Morris, “Building a Post-Brexit Immigration System for the Economic Recovery,” 2020, https://www.ippr.org/files/2020-11/post-brexit-migrationnov20.pdf
- ^ Charlesworth and Watt, “The Real Cost of a Fair Adult Social Care System .”
- ^ Source: Personal Social Services Survey of Adult Carers in England, 2018–19.
- ^ Carers UK, “Carers at Breaking Point: Making the Case for Carers’ Breaks in England,” 2019, https://www.carersuk.org/images/News__campaigns/GiveUsaABreak_Aug19_FINAL.pdf
- ^ Source: ONS Population Projections, https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationprojections/bulletins/nationalpopulationprojections/2018based
- ^ Linda Pickard, “A Growing Care Gap’ the Supply of Unpaid Care for Older People by Their Adult Children in England to 2032,” Ageing and Society 35, no. 1 (2015): 96–123, https://doi.org/10.1017/S0144686X13000512
- ^ Wittenberg, Hu and Hancock, “Projections of Demand and Expenditure on Adult Social Care 2015 to 2040.”
- ^ Natasha Curry, Sophie Castle-Clarke and Nina Hemmings, “What Can England Learn from the Long-Term Care System in Germany?,” Nuffield Trust, 2019, https://www.nuffieldtrust.org.uk/research/what-can-england-learn-from-the-long-term-care-system-in-germany
- ^ We use UKMOD version A.2.5.1 for our analysis. UKMOD is maintained, developed and managed by the Centre for Microsimulation and Policy Analysis at the Institute for Social and Economic Research (ISER), University of Essex. The process of extending and updating UKMOD is financially supported by the Nuffield Foundation.
- ^ James Browne, “Principles of Tax Reform: A Post-Covid Opportunity to Build a Fairer System,” 2021, https://institute.global/sites/default/files/articles/Principles-of-Tax-Reform-A-Post-Covid-Opportunity-to-Build-a-Fairer-System.pdf
- ^ Stuart Adam and Helen Miller, “Taxing Work and Investment across Legal Forms: Pathways to Well-Designed Taxes,” IFS Report (Institute for Fiscal Studies, 2021), https://doi.org/10.1920/RE.IFS.2021.0184
- ^ Natasha Curry, Sophie Castle-Clarke and Nina Hemmings, “What Can England Learn from the Long-Term Care System in Japan?,” 2018, https://www.nuffieldtrust.org.uk/files/2018-06/learning-from-japan-final.pdf
- ^ Younger people would still lose out in two respects. First, the self-employed would still face an increase in NICs. Second, as employer NICs would still be increased, this may be passed on to employees in the form of lower wages.
- ^ Stuart Adam et al., “Revaluation and Reform: Bringing Council Tax in England into the 21st Century,” 2020, https://www.ifs.org.uk/uploads/R168-Revaluation-and-reform-bringing-council-tax-in-England-into-the-21st-century-updated.pdf
- ^ https://www.conservativehome.com/platform/2021/02/john-stevenson-property-tax-reform-is-key-to-levelling-up-the-country-and-the-conservatives-electoral-chances.html.
- ^ Andy Summers and Arun Advani, “How Much Tax Do The Rich Really Pay And Could They Pay More?: New Evidence from Tax Microdata in the UK,” CAGE Policy Briefing, 2020, https://warwick.ac.uk/fac/soc/economics/research/centres/cage/manage/publications/bn27.2020.pdf
- ^ Helen Miller, Thomas Pope and Kate Smith, “Intertemporal Income Shifting and the Taxation of Owner-Managed Businesses,” Institute for Fiscal Studies Working Paper W19/25 (2019), https://doi.org/10.1920/wp.ifs.2019.1925
- ^ IFF Research, “Capital Gains Tax Entrepreneurs’ Relief: Behaviours and Motivations,” HMRC Research Report, 2017, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/663877/HMRC_Report_456_CGT_ER.pdf
- ^ Shreya Nanda, “Reforming the Taxation of Income from Wealth,” 2019, https://www.ippr.org/files/2019-11/capital-gains-tax-briefing.pdf
- ^ The IPPR recommend this as part of their package, but do not attempt to cost it, claiming that the revenue impact would be small. See Shreya Nanda and Henry Parkes, “Just Tax: Reforming the Taxation of Income from Wealth and Work,” 2019, https://www.ippr.org/files/2019-09/just-tax-sept19.pdf
- ^ Source: HMRC Statistics, Numbers of Taxpayers and Registered Traders, https://www.gov.uk/government/statistics/numbers-of-taxpayers-and-registered-traders
- ^ Lilley, “Solving the Social Care Dilemma? A Responsible Solution.”
- ^ OECD, Help Wanted? Providing and Paying for Long-Term Care.
- ^ Ipsos Mori, Understanding Public Attitudes to Social Care Funding Reform in England Report Prepared for the Health Foundation.
- ^ Rowena Crawford, “The Use of Wealth in Retirement,” IFS Briefing Note, BN236 (2018).
- ^ This is the famous r<g condition, which is important for the sustainability of public debt: when interest rates on government borrowing are lower than the growth rate, it means that public debt remains sustainable as debt will accumulate less quickly than the economy grows.