Should the planned cap on liability for care costs be uniform across England?

31 October 2016

A new briefing paper presenting data on regional variations in care costs has been published by the Care and State Pension Reform project (CASPeR) as part of a project funded by the Nuffield Foundation.

The briefing paper addresses the question of whether the planned cap on liability to meet care costs should be uniform across England. It sets out the different dimensions of equity that are relevant to the debate about regional variations in the care cap, namely that people should be assured that: 

  • However high their life-time care costs they will be left with a minimum level of savings.
  • Whatever their resources they will be required to spend no more on their care than a specified amount that is equal for all.
  • Whatever their resources and however high their annual care costs they will not be required to fund their own care for more than a specified number of years which is equal for all.

The CASPeR briefing paper finds that the case for and against a variable cap includes: 

  • The differences in disability-free life expectancy suggesting residents of more deprived areas can expect longer periods of care toward the end of life.
  • Higher care home fees in more affluent areas affect the rate people may reach the cap.
  • Differences in income and savings mean that people from more deprived areas will spend-down a higher proportion of their savings before reaching the cap.
  • A varying cap would be complex to administer when service users move area.
  • Uniformity of expenditure across the country may be regarded as more important than other aspects of equity.

Raphael Wittenberg, Associate Professorial Research Fellow from the Personal Social Services Research Unit at the London School of Economics, lead author of the briefing note and part of the CASPeR research team said:

“There is scope for debate about whether the cap on liability to meet care costs should be uniform across the country or vary by region or area. This issue merits policy consideration, which should be informed by the data and discussion in our briefing note about regional variation in relevant variables such as average care home fees.”

Ruth Hancock, Professor in the Economics of Health and Welfare at University of East Anglia, also part of the CASPeR research team said:

“The fact that care home fees are higher in some parts of the country than others does not necessarily mean that the planned cap should vary for this reason. What might be a more constructive debate is what the aim is of the cap; for example, to place a ceiling on the amount people have to spend on their care, or protect a proportion of their savings or leave them with a minimum level of savings after meeting their care costs, and whether the cap should be uniform across the country or vary because of this.”