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who cares, and who pays?

11 July 2012

Understandably, media attention on today’s Social Care White Paper will focus on the so called “death tax” proposals, and the approach to implementing the Dilnott recommendations on funding.

But we are also seeing an ambitious attempt to simplify the legal framework for access to care, which is almost inevitably criticised as an inconsistent and complex patchwork in any judgment dealing with these issues.

The proposals promise national standards to end the “postcode lottery”, where 152 local authorities currently each decide their own thresholds, with clearer and stronger individual legal rights for service users and their carers.

Complaints, challenges and compensation claims often come from unmet expectations, and disputes around the indistinct but crucial boundary between (free) health and (means tested, charged) social care. It will be vital to address this, and be clear how this national system for social care fits with the reformed NHS, driven by local decision making by 250-odd GP led Clinical Commissioning Groups.

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