Charging for care

The issue of funding of care and support affects people with dementia, carers and families. Alzheimer’s Society has campaigned for many years to end the “dementia tax”. At present, two-thirds (£17.4 billion) of the cost of dementia is paid by people with dementia and their families, either in unpaid care (£11.6 billion) or in paying for private social care (Alzheimer’s Society, 2014). This is in contrast to other conditions, such as heart disease and cancer, where the NHS provides care that is free at the point of use. Moreover, people with dementia and carers are paying for services that often do not deliver good quality care. Alzheimer's Society has found that people with dementia are willing to contribute to the cost of care but want a system that shares the cost of care between the individual and the state.

The Society calls for:

  • Implementation of the Dilnot proposals as a minimum. From 2017, in England and Wales, the government will cap the cost of care at £75,000 and increase the means-tested threshold at which people pay all their care costs to £123,000. Alzheimer's Society welcomes the government's intention to act in this area. However, we are concerned that the cap will only help a small number of people and people will still be liable for so-called “hotel costs”. In addition, the Dilnot proposals do not address the chronic underfunding of social care. Alzheimer’s Society calls for a national debate about how to improve quality, meet the level of unmet need, abolish the postcode lottery and end the dementia tax.
  • Improved financial support for carers. Many carers of people with dementia are worse off as a result of reduced income from work and higher costs (CEBR 2014). This is despite the fact that carers of people with dementia save an estimated £11 billion every year (Alzheimer's Society, 2014). Carers’ allowance should be increased and the unfair cap on carers’ earnings of £102 per week ended so that more people are able to afford to care
  • Services for “moderate” care needs. Alzheimer's Society believes that the current system of social care does not constitute a “safety net” as only poorer people with high levels of need are eligible for publicly funded care. At present, 87 per cent of adults live in councils that provide care at “critical” or “substantial” only (National Audit Office, 2014). This in contrast to the NHS, which provides care that is free at the point of use. Alzheimer’s Society calls for free care and support to be provided for “moderate” need.
  • Investment in care to protect the NHS. There can be no sustainable NHS without reform of social care funding. Lack of care and support results in unnecessary hospital admissions and keeps people with dementia in hospital for longer. Supporting people with dementia to leave hospital one week earlier would save at least £80milion a year (Alzheimer’s Society, 2009). Funding the care system appropriately will both enhance the sustainability of the NHS and enable a fair, affordable and high-quality social care system.
  • Improved care quality. The debate on future funding for social care is taking place in a context where people have to pay for care that can often not be of high quality. In order to address current widespread failings, the regulatory system must be strengthened and incentivise high-quality provision. For more information, please see our position statement on Care regulation.