The cost of introducing free personal care for older people could reach £132 million annually by 2044.
Health and Social Care Minister Claire Christian presented findings from the nursing, residential and home care project, warning the current system has “three well-documented problems”.
Opening the general debate, she told members it is financially unsustainable, unaffordable for many individuals and inequitable.
Government spending on long-term care for over-65s is currently £7.4m a year. Under a ‘do nothing’ baseline, this would rise to £11.7m by 2034 and £18.5m by 2044.
However, implementing a Scottish-style free personal care model would see costs soar to an estimated £65m by 2034 and £132m by 2044.
A Jersey-style mixed model would cost around £42m by 2034 and £66m by 2044.
“Self-funded care home fees can reach around £65,000 a year, and around one in two people aged 65 and over will incur care costs at some point,” Ms Christian told members.
Choices
A recent consultation received 1,227 responses, one of the highest response rates in recent years. Ms Christian said: “93% want reform, only 5% want to keep the status quo. 83% want a cap on what individuals pay. Around 65% are willing to contribute more, but only if funding is ring-fenced and transparently managed. 64% oppose using a person’s home value to pay for care.”
‘Do nothing is not an option’
Former health minister Lawrie Hooper argued strongly for reform, saying: “Do nothing is not an option at all.” He highlighted what the report calls “perverse incentives” in the current system.
“The system as it is will fund you to have certain types of care delivered in a certain way, but not fund you to have the same care delivered in a different way that may be better for you as an individual,” Mr Hooper said.
He suggested a ring-fenced social insurance levy could cost an average earner around £26 per month. He asked: “Think back to what you’re paying for your house insurance, for your car insurance, for your life insurance.
“The reality is £26 a month to make sure that if you do need care when you get into your later life, that it’s going to cover those costs for you, and you’re not going to have to sell your house, £26 a month is a pretty good deal.”
Concerns over provision
Kate Lord Brennan expressed frustration at the lack of government investment in residential care provision, particularly in the west of the island, which she said has no publicly run, funded, supported or commissioned residential care offering.
She said: “Frankly, the prospect that society as a whole should pay more tax to fund some unknown provision involving no choice under the guise of keeping people in their own homes longer, I’m sorry, it’s not going to fly, not in the constituency I represent.”
Treasury Minister Chris Thomas noted the issue has been debated for years, saying: “Does the mover share my regret that Mr Karran and Mr Robertshaw and Mr Watterson’s committee recommendations were not taken forward all those years ago? Then we could have had a fund already now.”
Human impact
Kirstie Morphet MLC gave a stark account of the current system’s reality.
“I know what the status quo looks like in practice. It is sitting at someone’s bedside after a fall or illness or slow deterioration of mobility when they are frightened and vulnerable, and instead of reassurance, they are being asked if they can afford to get washed and dressed every day,” she said.
She described people being asked “how many days a week can they afford to pay someone to heat up a meal for them, managing the rest of the week with cold meals” and whether “their 85-year-old wife [can] pick up the slack for the care that they cannot afford”.
“That is the reality of this current system, and it cannot continue,” Mrs Morphet said.
Cost
Dr Michelle Haywood added: “It’s often said that our residents want a high level of services but at cut-price costs. I think it’s time to be honest that services cost money, and we can’t keep pretending they don’t.”
The report sets out five options for consideration, including ‘do nothing’, implementing one of the new models, ‘do nothing plus’ with targeted regulatory reforms, prioritising investment in cost reduction, or a combination approach.
Chief Minister Alf Cannan however urged caution, saying: “I’m very cautious about using the word ‘free’, because fundamentally that is potentially misleading. It is not free. Somebody ultimately has to pay for it.”
During the debate, members suggested that the general election could prove a good time to test public mood for the options.