Council tax rises get go-ahead
Discussion
crankedup said:
REALIST123 said:
Don't know where you guys are located but where I am the services provided by contractors, like the bins, are the better ones.
Now you've touched on a subject with some relevance to me as my MIL is suffering with late stage vascular dementia and my wife and her sister are looking for good care for her.
Our experience of both private sector and public sector service has been pretty poor. From NHS/SS treatment, to local authority and private care in the home and in a care home the available care has been pretty disappointing, not to say useless in some respects. It seems the public sector are desperate to palm her off to the private sector and they just want their money. Having said that she currently has a private nurse visiting daily who seems very good. If costly.....
It's made worse by the fact that the old girl has to pay for all and any care having her own little bungalow and a few quid saved up over the years. So despite her and her late husband both paying NI for decades, now she needs something it's not there.
REALIST123 said:
XCP said:
Depends. I have knowledge of some care homes that are more akin to 4 star hotels, indoor swimming pools, cinemas etc.
I know of some very nice homes too but £1200 a week, or more, eats into assets very quickly. Actually a 4 star hotel could be less expensive. crankedup said:
CoolHands said:
"Social care covers the services run by councils, although often provided by external companies,"
True to form for the tories! Straight into the hands of private companies providing a s
t service. Looking after their mates.
Indeed that is the situation, and a shameful one at that.True to form for the tories! Straight into the hands of private companies providing a s
t service. Looking after their mates.You're right that society is best served by people looking after their own family members where possible. Millions of people in the UK already do this for their relatives, and a huge number of people also help support the elderly and infirm through voluntary organisations. It is not so obvious that there is a great untapped resource of tax-free care sitting out there in society.
There's no simple, single solution for the problems of providing long-term care for the elderly, but here are a couple of things I'd try to address if I was Benign Dictator of the Day. (1) Bed blocking caused by the NHS and local authority not having shared responsibility and/or funding for patients. (2) A perception that it is unfair to "deprive" people of their inheritance by requiring their elderly relatives to pay for their own care out of their assets.
While elderly patients are a financial burden to the local authority it's natural that the LA will try to leave them under NHS care for as long as possible. It makes perfect sense for them to do so from their own perspective, while equally obviously it is horrendously inefficient for the country as a whole. Keeping the patient in an NHS bed costs something like ten times more than it would cost the LA to provide the required care and support. Given there is a natural organisational boundary between the type of care provided by the an NHS hospital and a local authority that you probably don't want to blur, it strikes me that you'd want money to follow the patient so that they aren't a financial burden to the local authority. If the LA takes on care for an elderly patient, that should trigger the LA to receive additional funding. Perhaps the idea of having GPs as purchasers of care for their patients could be extended to manage the transfer of patients from NHS beds back into the community?
And the thorny subject of means-tested care and inheritance tax. I find it hard to see how we can justify allowing someone to squirrel away assets for their descendants while simultaneously burdening the state with the cost of their care. Spending your own assets to look after yourself at the end of your life seems to me to be an entirely reasonable thing to do. I think you can probably dream up a scheme to do this in a humane way to avoid forcing people to sell their home, for example. You'd need to do something like take a charge against the family home that allows the elderly patient and any dependent relatives to remain in the home until they've all snuffed it, at which point the building gets sold and the local authority gets their cut. It ought to be pretty cheap for the LA to finance the gap between services being used and deferred, means-tested payment being received. Of course this will encourage people to do things like trying to give away assets, or downsizing to try to reduce the potential claw-back, but I imagine that can be mitigated with something like the 7-year rule used for gifts in IHT liability calculation, possibly with tapering.
XCP said:
REALIST123 said:
XCP said:
Depends. I have knowledge of some care homes that are more akin to 4 star hotels, indoor swimming pools, cinemas etc.
I know of some very nice homes too but £1200 a week, or more, eats into assets very quickly. Actually a 4 star hotel could be less expensive. I think we are all aware of that but to most it's simply unaffordable.
After paying for it over the years my in laws would wonder what happened to:
"The NHS was created out of the ideal that good healthcare should be available to all, regardless of wealth. When it was launched by the then minister of health, Aneurin Bevan, on July 5 1948, it was based on three core principles:
that it meet the needs of everyone
that it be free at the point of delivery
that it be based on clinical need, not ability to pay."
They were both paying for it from day one.
REALIST123 said:
Now you've touched on a subject with some relevance to me as my MIL is suffering with late stage vascular dementia and my wife and her sister are looking for good care for her.
Our experience of both private sector and public sector service has been pretty poor. From NHS/SS treatment, to local authority and private care in the home and in a care home the available care has been pretty disappointing, not to say useless in some respects. It seems the public sector are desperate to palm her off to the private sector and they just want their money. Having said that she currently has a private nurse visiting daily who seems very good. If costly.....
It's made worse by the fact that the old girl has to pay for all and any care having her own little bungalow and a few quid saved up over the years. So despite her and her late husband both paying NI for decades, now she needs something it's not there.
This time last year my MIL was seriously ill, had been for some months but now required palitive care. We visited two care homes that were qualified to provide care, the first was atrocious, being dirty, old fashioned, inpersonal. I could go on about it, suffice to say I wouldn't have left. dog there. The second care home was a BUPA home, the contrast could not have been greater between it and the first home. Fantastic, they even painted my MIL private room in a pastel shade which she had always loved. All this comes at a price of around 4K month, as others have mentioned decent care costs and if that care is on a long term basis, enough said.
Edited by crankedup on Wednesday 14th December 10:35
ATG said:
Ian Geary has already given an excellent reply to CoolHands' post and I'd recommend reading it if you haven't done so already.
You're right that society is best served by people looking after their own family members where possible. Millions of people in the UK already do this for their relatives, and a huge number of people also help support the elderly and infirm through voluntary organisations. It is not so obvious that there is a great untapped resource of tax-free care sitting out there in society.
There's no simple, single solution for the problems of providing long-term care for the elderly, but here are a couple of things I'd try to address if I was Benign Dictator of the Day. (1) Bed blocking caused by the NHS and local authority not having shared responsibility and/or funding for patients. (2) A perception that it is unfair to "deprive" people of their inheritance by requiring their elderly relatives to pay for their own care out of their assets.
While elderly patients are a financial burden to the local authority it's natural that the LA will try to leave them under NHS care for as long as possible. It makes perfect sense for them to do so from their own perspective, while equally obviously it is horrendously inefficient for the country as a whole. Keeping the patient in an NHS bed costs something like ten times more than it would cost the LA to provide the required care and support. Given there is a natural organisational boundary between the type of care provided by the an NHS hospital and a local authority that you probably don't want to blur, it strikes me that you'd want money to follow the patient so that they aren't a financial burden to the local authority. If the LA takes on care for an elderly patient, that should trigger the LA to receive additional funding. Perhaps the idea of having GPs as purchasers of care for their patients could be extended to manage the transfer of patients from NHS beds back into the community?
And the thorny subject of means-tested care and inheritance tax. I find it hard to see how we can justify allowing someone to squirrel away assets for their descendants while simultaneously burdening the state with the cost of their care. Spending your own assets to look after yourself at the end of your life seems to me to be an entirely reasonable thing to do. I think you can probably dream up a scheme to do this in a humane way to avoid forcing people to sell their home, for example. You'd need to do something like take a charge against the family home that allows the elderly patient and any dependent relatives to remain in the home until they've all snuffed it, at which point the building gets sold and the local authority gets their cut. It ought to be pretty cheap for the LA to finance the gap between services being used and deferred, means-tested payment being received. Of course this will encourage people to do things like trying to give away assets, or downsizing to try to reduce the potential claw-back, but I imagine that can be mitigated with something like the 7-year rule used for gifts in IHT liability calculation, possibly with tapering.
Interesting read, as you rightly say no easy solutions are available and what is available can be open to abuse or cheating.You're right that society is best served by people looking after their own family members where possible. Millions of people in the UK already do this for their relatives, and a huge number of people also help support the elderly and infirm through voluntary organisations. It is not so obvious that there is a great untapped resource of tax-free care sitting out there in society.
There's no simple, single solution for the problems of providing long-term care for the elderly, but here are a couple of things I'd try to address if I was Benign Dictator of the Day. (1) Bed blocking caused by the NHS and local authority not having shared responsibility and/or funding for patients. (2) A perception that it is unfair to "deprive" people of their inheritance by requiring their elderly relatives to pay for their own care out of their assets.
While elderly patients are a financial burden to the local authority it's natural that the LA will try to leave them under NHS care for as long as possible. It makes perfect sense for them to do so from their own perspective, while equally obviously it is horrendously inefficient for the country as a whole. Keeping the patient in an NHS bed costs something like ten times more than it would cost the LA to provide the required care and support. Given there is a natural organisational boundary between the type of care provided by the an NHS hospital and a local authority that you probably don't want to blur, it strikes me that you'd want money to follow the patient so that they aren't a financial burden to the local authority. If the LA takes on care for an elderly patient, that should trigger the LA to receive additional funding. Perhaps the idea of having GPs as purchasers of care for their patients could be extended to manage the transfer of patients from NHS beds back into the community?
And the thorny subject of means-tested care and inheritance tax. I find it hard to see how we can justify allowing someone to squirrel away assets for their descendants while simultaneously burdening the state with the cost of their care. Spending your own assets to look after yourself at the end of your life seems to me to be an entirely reasonable thing to do. I think you can probably dream up a scheme to do this in a humane way to avoid forcing people to sell their home, for example. You'd need to do something like take a charge against the family home that allows the elderly patient and any dependent relatives to remain in the home until they've all snuffed it, at which point the building gets sold and the local authority gets their cut. It ought to be pretty cheap for the LA to finance the gap between services being used and deferred, means-tested payment being received. Of course this will encourage people to do things like trying to give away assets, or downsizing to try to reduce the potential claw-back, but I imagine that can be mitigated with something like the 7-year rule used for gifts in IHT liability calculation, possibly with tapering.
personally I do not believe the private sector should be involved in elderly care at any level. This is not a business which should be related to making profit from, I would like to see local councils take the responsibility for full provision, maybe that way I would be less inclined to object to an increase in Council tax purely ring fenced for elderly care.
REALIST123 said:
Don't know where you guys are located but where I am the services provided by contractors, like the bins, are the better ones.
t.They want bins left out in pole position for them, but will barely make the effort to put back within a 500 metre radius of where they picked them up. Randomly not picking up a bin. Totally ignore re-collection request when it is reported.
Roads falling apart but will install yet more speed bumps on said roads. Banning motorbikes from their bus lanes even though tfl allow them in their ones. Cameras everywhere but no help to victims - only traffic transgressions. Not being able to take anything to the dump so everything gets flytipped. Stop Mrs Mighins from having a kitchen extension but allow developers to build 6 storey social housing blocks Etc.
My Dad is in a care home in Doncaster and so far the care is great. Staffed by local people who speak good English and actually care. In others there is a mix of low paid low moral staff.
How did we get to the point where care for our old people is in crisis? To my mind it all began when people were moaning about the costs of council run old peoples homes costing X out of rates. So when council cuts were needed the old were a soft target as no one cared as they were not old.
Homes were closed and the staff made redundant and private companies sprang up to take the slack. It worked and money was being made but it saved the councils millions. But as there were more cuts the councils pay less. For example Doncaster pay all homes a flat fee of £425 per person, if they fund it, half what there true home fee is, so they look to people who have the ability to pay to make up the profit.
This is easier in Doncaster as a care home is cheap compared with what one would be in Bristol or London to buy and run.
We also have a growing old population, medical intervention means 80 is not really that old but the body is shot for many meaning they cannot cope alone and this problem will get worse.
Now it is a thorny subject but the even worse problem that us building is many people see now that there is no point in working hard, buying a home and having assets as if they need care it is taken by the state to pay for care. If they had spent every penny they are cared for free. I know of two people in their 40's who have cashed in their pension for this very reason. Stupidly in my opinion but they are not alone in this feeling of being punished for prudence.
I for one would pay extra to give dignity to all older people, I will hopefully be one myself, but it is hard for many to accept a civil society should look after their old people and if that costs the equivalent of a costa coffee a week extra is that too much to ask?
There are too many selfish people who think of now and nothing or nobody else. Spend some time in a care home watching old people and you will see why this must get more money.
The argument is that a fraction of the Aid money that has been stolen given by the UK would transform the care provided, but there are no celebrities doing a record for these, no trendy facebook campaigns no one who has power speaking up for old people.
How did we get to the point where care for our old people is in crisis? To my mind it all began when people were moaning about the costs of council run old peoples homes costing X out of rates. So when council cuts were needed the old were a soft target as no one cared as they were not old.
Homes were closed and the staff made redundant and private companies sprang up to take the slack. It worked and money was being made but it saved the councils millions. But as there were more cuts the councils pay less. For example Doncaster pay all homes a flat fee of £425 per person, if they fund it, half what there true home fee is, so they look to people who have the ability to pay to make up the profit.
This is easier in Doncaster as a care home is cheap compared with what one would be in Bristol or London to buy and run.
We also have a growing old population, medical intervention means 80 is not really that old but the body is shot for many meaning they cannot cope alone and this problem will get worse.
Now it is a thorny subject but the even worse problem that us building is many people see now that there is no point in working hard, buying a home and having assets as if they need care it is taken by the state to pay for care. If they had spent every penny they are cared for free. I know of two people in their 40's who have cashed in their pension for this very reason. Stupidly in my opinion but they are not alone in this feeling of being punished for prudence.
I for one would pay extra to give dignity to all older people, I will hopefully be one myself, but it is hard for many to accept a civil society should look after their old people and if that costs the equivalent of a costa coffee a week extra is that too much to ask?
There are too many selfish people who think of now and nothing or nobody else. Spend some time in a care home watching old people and you will see why this must get more money.
The argument is that a fraction of the Aid money that has been stolen given by the UK would transform the care provided, but there are no celebrities doing a record for these, no trendy facebook campaigns no one who has power speaking up for old people.
spaximus said:
My Dad is in a care home in Doncaster and so far the care is great. Staffed by local people who speak good English and actually care. In others there is a mix of low paid low moral staff.
How did we get to the point where care for our old people is in crisis? To my mind it all began when people were moaning about the costs of council run old peoples homes costing X out of rates. So when council cuts were needed the old were a soft target as no one cared as they were not old.
Homes were closed and the staff made redundant and private companies sprang up to take the slack. It worked and money was being made but it saved the councils millions. But as there were more cuts the councils pay less. For example Doncaster pay all homes a flat fee of £425 per person, if they fund it, half what there true home fee is, so they look to people who have the ability to pay to make up the profit.
This is easier in Doncaster as a care home is cheap compared with what one would be in Bristol or London to buy and run.
We also have a growing old population, medical intervention means 80 is not really that old but the body is shot for many meaning they cannot cope alone and this problem will get worse.
Now it is a thorny subject but the even worse problem that us building is many people see now that there is no point in working hard, buying a home and having assets as if they need care it is taken by the state to pay for care. If they had spent every penny they are cared for free. I know of two people in their 40's who have cashed in their pension for this very reason. Stupidly in my opinion but they are not alone in this feeling of being punished for prudence.
I for one would pay extra to give dignity to all older people, I will hopefully be one myself, but it is hard for many to accept a civil society should look after their old people and if that costs the equivalent of a costa coffee a week extra is that too much to ask?
There are too many selfish people who think of now and nothing or nobody else. Spend some time in a care home watching old people and you will see why this must get more money.
The argument is that a fraction of the Aid money that has been stolen given by the UK would transform the care provided, but there are no celebrities doing a record for these, no trendy facebook campaigns no one who has power speaking up for old people.
Absolutely agree, sadly it appears that until people are affected personally and therefore have real World experience of this situation these people see the care industry as another 'bloody nuisances cost'. Society needs to get back to basics imo.How did we get to the point where care for our old people is in crisis? To my mind it all began when people were moaning about the costs of council run old peoples homes costing X out of rates. So when council cuts were needed the old were a soft target as no one cared as they were not old.
Homes were closed and the staff made redundant and private companies sprang up to take the slack. It worked and money was being made but it saved the councils millions. But as there were more cuts the councils pay less. For example Doncaster pay all homes a flat fee of £425 per person, if they fund it, half what there true home fee is, so they look to people who have the ability to pay to make up the profit.
This is easier in Doncaster as a care home is cheap compared with what one would be in Bristol or London to buy and run.
We also have a growing old population, medical intervention means 80 is not really that old but the body is shot for many meaning they cannot cope alone and this problem will get worse.
Now it is a thorny subject but the even worse problem that us building is many people see now that there is no point in working hard, buying a home and having assets as if they need care it is taken by the state to pay for care. If they had spent every penny they are cared for free. I know of two people in their 40's who have cashed in their pension for this very reason. Stupidly in my opinion but they are not alone in this feeling of being punished for prudence.
I for one would pay extra to give dignity to all older people, I will hopefully be one myself, but it is hard for many to accept a civil society should look after their old people and if that costs the equivalent of a costa coffee a week extra is that too much to ask?
There are too many selfish people who think of now and nothing or nobody else. Spend some time in a care home watching old people and you will see why this must get more money.
The argument is that a fraction of the Aid money that has been stolen given by the UK would transform the care provided, but there are no celebrities doing a record for these, no trendy facebook campaigns no one who has power speaking up for old people.
edh said:
Maybe we could fund it from the windfall gains that old people have made from their houses?... No-one "worked hard" for the massive inflation of house values.
Or are the next generation too greedy for their inheritance and think they "deserve" that unearned wealth?
Death tax already deals with that - if it's too low increase it. Or change the rules. Or are the next generation too greedy for their inheritance and think they "deserve" that unearned wealth?
edh said:
Maybe we could fund it from the windfall gains that old people have made from their houses?... No-one "worked hard" for the massive inflation of house values.
Or are the next generation too greedy for their inheritance and think they "deserve" that unearned wealth?
Home owners already do just that, they do it by paying the council tax. The bigger your homes value the more you pay. If you are in council or social housing you pay less.Or are the next generation too greedy for their inheritance and think they "deserve" that unearned wealth?
Inheritance tax is also paid by many home owners families so again they pay.
House prices have always gone up and we used to be able to fund care properly in the past, we could now.
In the News to day Hunt is saying we now need to save for our long term care in the same way we do for pensions, we do it is called the NI contribution.
spaximus said:
edh said:
Maybe we could fund it from the windfall gains that old people have made from their houses?... No-one "worked hard" for the massive inflation of house values.
Or are the next generation too greedy for their inheritance and think they "deserve" that unearned wealth?
Home owners already do just that, they do it by paying the council tax. The bigger your homes value the more you pay. If you are in council or social housing you pay less.Or are the next generation too greedy for their inheritance and think they "deserve" that unearned wealth?
Inheritance tax is also paid by many home owners families so again they pay.
House prices have always gone up and we used to be able to fund care properly in the past, we could now.
In the News to day Hunt is saying we now need to save for our long term care in the same way we do for pensions, we do it is called the NI contribution.
spaximus said:
...
In the News to day Hunt is saying we now need to save for our long term care in the same way we do for pensions, we do it is called the NI contribution.
We all need to get out of the romantic notion that NI will cover all our health needs for the rest of our days. It may have been able to in 1911. Not a chance today. It's just one more tax to add to the insufficient pool to cover our expenditure. In the News to day Hunt is saying we now need to save for our long term care in the same way we do for pensions, we do it is called the NI contribution.
As indicated above, quality care costs money. £48k per annum in the example noted. The person on an average wage will clock up something like 5k per annum in NI payments (theirs plus employers). Even assuming a 40yr working life at that average, it doesn't take long for care costs to strip away at it, especially as we are all living longer.
The NHS and centrally funded care in this country will need to be stripped back to basic essentials in my lifetime IMO. There are too many people leaning on it for too many things and for too long for it to be sustainable. Even if it was the most efficient organisation on earth.
Providing for yourself wherever possible is the only approach with a chance of a happy outcome. In reality it's always been that way.
BlackLabel said:
And what options would you suggest to ensure authorities can keep delivering the services, which, last time I checked, are still very much in demand?Govt. say that councils have had a real term increase in spending power, but that analysis includes adding in these projected increases in council tax charges, and the smoke and mirrors addition of public health grant, which just funded a whole new set of responsibilities.
Compared to rising demand for adult social care (ageing pop, more severe needs), children's social care (better survival rate for severely disabled children, legal decisions to fund LAC through university and tougher ofsted requirements) and homelessness (generation rent, poorly functioning private sector rental market) average funding is plummeting.
But no-one wants to talk about what councils should stop providing.
Ok, people can moan about pensions, but that's just part of agreed remuneration in a sector that has a longer term reward focus rather than a bonus culture.
So instead we end up with discussions about how much councils spend on biscuits.
The Dilnot review came up with cross party proposals on adult care, yet the government, yet again, just dodged a long term issue.
Ian
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