Friday, 22 January 2010

Need care? Give us your house!

In the UK a person is entitled to free NHS medical care. Should a person then require 'long term care' at home, in sheltered housing or in a nursing home a person must pay for their care (often between £600-£1000 a week for those needing nursing care) until their assets fall below £23000, when the council will help pay, (they won't actually pay for everything until you own less than £14000). In short you must sell all your assets (i.e your house unless a dependent is living in it) to pay for your long term care until nearly bankrupt. The local council will 'help' by only assessing you based on assets excluding home for the first 12 weeks of your care. After that, you had better have your house sold because they will charge you like you own it's value in ready cash. 12 weeks to sell a house. 12 weeks - would anyone get a good price for it? Of course if you were clever you'd have split your assets, changed the deeds to your house or moved your elderly sister in to avoid your full assets being assessed and allowing you to keep your home.

24 hr care costs about £600-£1000 a week (in a council supported residence). So with £103 nursing allowance, £70.35 attendance allowance and £95 pension a week, that leaves a pensioner with about £300-£700 to pay a week. How many private pensions cover that? And that's not accounting for if the pensioner should maybe want some *nice* food, to go out, a birthday present for the grandkids, new clothes or anything to make their lives more fun. The joint savings of couples can be decimated by paying for the long-term care of just one. leaving two victims of circumstance and unexpected disability. Pensioners who paid taxes all their working lives expect to be cared for. And they are, until that care takes longer than a month or so.

I understand why this is happening. The population is aging and the younger generations cannot carry the tax burden of caring for the older ones. Part of me thinks this is fair, if you can pay...you should, put the money back into the economy now and forget leaving a tidy nest egg for the kids. But the other part of me can't make the leap between paying for NHS care and not paying for long term care. Dementia or disability are not certainities or life-style choices, why should caring for them be any different to caring for people who have traffic accidents, diseases or cancer? Why should the taxpayer pay for people who have sufficient money to merely get old naturally? Probably for the same reason that the taxpayer pays for these same people with sufficient money to have midwives and ante-natal care.

At the moment the system essentially penalises people who have saved or bought their house (that's the middle classes then); so nearly all political parties have sat up and taken notice offering a variety of options to the country. The main problem revolves around the problem that there is no money for care *now*. The government's suggestions (which completely forgot about accomodation costs) are below.

1. A partnership approach, which proposes that the government and the individual who needs care share the costs, with the government paying between a quarter and a third or more for people on a low income.

Seems a lot like what they're doing already except with local authorities

2. An optional insurance-based model, which would also see the government paying between a quarter and a third of the costs, but would allow individuals to pay £20,000 to £25,000 to cover themselves against the remaining costs of care.

So that would be private health insurance then?

3. A compulsory state insurance scheme under which everyone who can afford it pays between £17,000 and £20,000 – and receives free care in return.

Hmm. Just peachy if you're rich. Destruction of your hard earned retirement nest egg in an unexpected tax if you're not.

Personally I don't like any of them, but I suspect there is no easy way out of this mess. I think perhaps the money should come from an income tax, hence the risk of paying for long term care is spread out amongst the entire population at an affordable cost. Where have I heard it before though? Oh yes, funding the NHS - who should have been paying for long term care all along. But hindsight is a wonderful thing and an answer needs to be found for the situation now. And that is why I rage. I rage at the lack of an easy answer.

Monday, 18 January 2010

Historic toilets

Apologies for the absence, yet again my Christmas period was complicated with relatives going into hospital. Never fear though the mighty gingerbread project is not forgotten! It'll just have to be a pre-wedding-anniversary gingerbread extravaganza.

But onto important matters. Loos. The John Ryland library loos to be precise, which are AWESOME. Victorian in extremis. It's like walking into the past for a wee. Clearly other people feel the same sense of awe at the loos and there are signs up reminding them not to take photographs. However here is one from the Manchesterzedder's blog.

Of course the John Ryland Library is worth a vist anyday of the week. It is stunning and when I rule the world I shall live in it, happily polishing all the wood pannelling, reading books on cunning lecturns and naming all the gargoyles. Everything is beautiful in the church-like library building, built by the possibly gold-digging 3rd Mrs Ryland (She was a lot younger than her millionaire husband). Gold digging or not she was pretty smart insisting that her books be stored under electric lighting instead of gas whilst also being very picky about the doors and railings. In honour of the beauty of this place the modern extension is even tasteful. All libraries should look like this. All books should be stored like this. All loos should make you want to take a photograph.