News Story

Care Bill will change lives – but the Government must go further

October 22, 2013

More than a quarter of a million older and disabled people who need support for day-to-day tasks, and the families who care for them, won’t see the benefits of the Government’s welcome overhaul of social care, because of a plan to tightly ration who gets support.

The figures come from new analysis of London School of Economics (LSE) research by the Care and Support Alliance, which represents 75 leading organisations and charities.

The CSA describes the Care Bill as a ‘real achievement’.

But as Lords debate the bill, the CSA is now urging the Government to be ‘bold’ and ensure its vision of social care becomes a reality for everyone by re-thinking its plans for eligibility and putting in place the funding to make it happen.

The call comes ahead of a week parliamentary events and social media action.

Parliament is debating moves to create a new system that ends the postcode lottery and caps the cost of care at £72,000.

It follows evidence that cash-strapped councils are squeezing the number of people eligible for care and rationing support for those still in the system.

Recently the CSA welcomed a series of positive amendments to the Care Bill, which further improve the system.

But the coalition of charities will now tell MPs and Lords that they now need to make sure as many people as possible see the benefits of the changes.

Outside of these parliamentary debates, the government is planning to restrict the number of people in the system.

Documents reveal that the Department of Health intends to set the national threshold (p6) for who’s in and who’s out of the system at the higher ‘substantial’ level that many councils have recently moved to.

According to new analysis of research conducted by the London School of Economics[i], setting the threshold at this level means approximately 362,000 older and disabled people will not receive any support from their council (see below for details). They will have to pay for their own care without their costs being capped.

There are people – misleadingly described as having ‘moderate needs’ – who are unable to undertake several aspects of personal care, or of work, education or training.

The new analysis of the research by LSE suggests the system is under-funded by £2.8bn[ii].

Eligibility is inextricably linked to spending decisions. The CSA argues that a lower threshold also makes economic sense (see below).

As part of a week of action, Paralympians Sophie Christiansen and Hannah Cockcroft are helping Care and Support Alliance members to make the case to MPs.

Sophie has written a blog about the importance of social care to her personally

Hannah is attending a Britain Cares parliamentary event on Tuesday 22nd October.

The CSA will also be asking older and disabled people and their families to share on social media how they use social care to do things everyone else takes for granted.

Richard Hawkes, chair of the Care and Support Alliance, says:
“The social care system is on its knees. Older and disabled people are telling us they’re simply not getting the support they need to get up, get washed and dressed, and live independently. Cash-strapped councils are rationing support.

“The Care Bill is the first attempt for generations to radically overhaul the creaking system. The Government has put forward bold proposals to bring social care into the 21 century. It’s a real achievement.

“Now the Government needs to have the courage to see its plans through. It needs to keep going, keep building, and keep listening.

“It’s becoming clear that a huge number of people that need support will not see any of the benefits of the new system.

“Plans to tightly restrict who gets council care mean more than a quarter of a million people may have to find their own support without any protection from spiralling costs.

“Ultimately we want the bill to genuinely promote prevention – rather than crisis care.

“The CSA wants the Government to set the bar for who gets and who doesn’t get council support at a level that includes everyone who needs support live independently.

“Hand-in-hand with this decision has to be a commitment to properly fund the social care system. Councils continue to say that they simply don’t have the resources they need.”

Sophie Christiansen said:
“Social care can often be fairly invisible in society.  It’s hardworking, often low-paid carers behind closed doors, supporting those of us who need it to do the basics in life – like getting washed, dressed and out of the house.  And if you can’t do those things, what can you do?

“It was so important to me to fulfil my ambitions and win Gold last year.  Everyone in Britain has hopes and ambitions for their life – and social care is vital support to enable them to do it.  Whether it’s studying, working or taking part in the community, so many things begin with good care and support.

“As a Paralympian, you could look at me and think my life is all sorted, but I still struggle to get the right funding and support.  If it’s tough for me as a high-profile figure, what is it like for other people?”


If – like many older and disabled people – you need support to get up, get dressed, get washed and live independently, you can request it from your council – an example could be a support worker who’ll come to your home. That’s social care. Their families rely on it too, to provide extra support so that they can juggle work and care and live healthy lives.

At the moment individual councils can decide the level of need you have to reach before you’re eligible for council-funded support. This has created a postcode lottery, as more and more councils decide to tightly ration who gets care and support.

In May, Government figures (see 2.5 table 8) showed approximately 86% of councils now put the bar for who gets and who doesn’t care at a higher level. Councils point to a chronic lack of funding in the system. Research by LSE suggests the system is under-funded by £2.8bn[iii].

In response, the Care Bill is going to introduce a national level of eligibility.

But the legislative process means the decision about where that level is drawn has to sit outside of the bill, because Parliament can’t make a decision on a threshold until after it’s agreed that there needs to be one in the first place.

Earlier this year Minister Norman Lamb revealed he wanted to set the bar for who gets local care at the higher level that many councils are moving to.

This effectively shuts the door on people who are unable to undertake several aspects of personal care, or of work, education or training.

Under the current system they are described as people with ‘moderate needs’.

But the CSA argues that’s a misleading description which doesn’t capture the significant impact not having support has on a person’s life. Without support they can’t live independently and risk falling into crisis.

According to the research conducted by London School of Economics[iv], the move would see the following people ineligible for council care:

  • 69,000 working age disabled people with moderate needs not in the system
  • 36,000 working age disabled people with moderate needs currently in the system
  • 8,000 disabled people with substantial or critical needs who would also be brought into the system with a moderate threshold
  • 170,000 older people (over 65s) with moderate needs not currently in the system
  • 65,000 older with moderate needs currently in the system
  • 14,000 older people with substantial or critical needs who would also be brought into the system with a moderate threshold

The final decision on where the national threshold will be set will be published for consultation in spring next year and voted on in autumn 2014.

The Care and Support Alliance wants the Government to set the threshold at ‘moderate’. 

The decision on eligibility is linked to Government spending commitments.

But there is also an economic case for making the change. Economic modelling on four different service types carried out by Deloitte in 2013 found that for every £1 spent on support for people with ‘moderate’ level needs, an average of £1.30 will be saved in the NHS, local and central government.


The Other Care Crisis is a report published by Scope, Mencap, The National Autistic Society, Sense and Leonard Cheshire Disability –

It is based on research by the London School of Economics, Personal Social Services Research Unit (2013) Implications of setting eligibility criteria for adult social care at moderate needs level –

About the Care and Support Alliance:

  • Set up in July 2009, the C&SA is a consortium of over 70 organisations that represent and support older and disabled      people, including disabled children, those with long-term conditions and their families, and campaigns to keep adult care funding and reform on the political agenda.