Does the cap fit?

In the early months of 2022, the prospects for better social care seemed as distant as ever. A last-minute amendment to the Health and Social Care Bill before Parliament meant that the proposed cap on individual care costs would turn out to offer less protection than the original proposals to people with modest savings and wealth, especially in places with lower house prices. Those in the North East, Yorkshire and the Humber, and the Midlands will be worst hit, having to contribute more towards care charges than those in London and the South East (Sturrock and Tallack, 2022). This appears to fly in the face of the government’s plans to ‘level-up’ parts of the country that have lagged behind economically. Once again, a government’s attempts to tackle social care caused political fur to fly, with a backbench rebellion over the proposed hike in National Insurance and the accusations that the health and social care levy amounted to a new ‘dementia tax’ on the working class. The government went on to win the House of Commons vote but lost the argument in the eyes of most independent commentators. ‘Poorly conceived’ and ‘a step in the wrong direction’, was the Health Foundation’s verdict (Health Foundation, 2021). The less-well-off losers from the change may well wonder, as the King’s Fund put it, ‘why the Prime Minister’s promise that no one need sell their house to pay for care will benefit wealthier people but doesn’t seem to apply to them’ (King’s Fund 2021a). For the Nuffield Trust, Natasha Curry lamented that the long hoped-for comprehensive plan to deliver lasting change still appeared to be a long way off (Nuffield Trust, 2021).

In the government’s defence, its proposals for funding reform in the Health and Social Care Bill do represent an overall improvement over the current system, particularly the substantial increase in the means-test threshold, though that is a very low bar given the well-chronicled and widespread deficiencies of the existing system.