‘Way forward’ needed as new report reveals cost of ‘free personal care’ for older adults in Wales

Researchers at Cardiff University’s Wales Governance Centre have unveiled a new report looking at the lessons that can be learnt from the introduction of Free Personal Care in Scotland, and examining the possible implications of implementing the same policy in Wales.

Arguing that a way forward is needed on the future funding of older adult social care, the academics reveal in the new report that the option of providing ‘free personal care’ to older adults along the lines of Scotland could cost around £300m per year (equivalent to 1.5% of the Welsh budget for day-to-day spending). However, the researchers acknowledge that the situation in Wales differs from Scotland in key respects, and that ongoing costs could be driven up because of Wales’ larger older population and high prevalence of frailty.

The Wales Fiscal Analysis report highlights that, having accounted for inflation, public spending on older adult social care fell by nearly 10%, from £1,058 to £956 per head between 2009–10 and 2018–19. This follows another Wales Fiscal Analysis report that highlighted the resourcing challenges facing the sector.

The researchers conclude that it is inevitable that Wales will have to spend more on social care over the next decade, and that this presents an opportunity to reconsider arrangements that currently govern how people pay for care.

Cian Siôn, one of the authors of the report, said:

“Free personal care is obviously attractive in Wales but there have always been concerns about whether we can afford it. Our report sets out an initial cost estimate for the policy and outlines the factors a more precise estimate would need to consider.

“Wales has already ameliorated some social care costs by placing a weekly cap on home care charges and increasing the asset threshold, above which, residents need to fund their own care costs. This means that the starting point for Wales in relation to free personal care would be different to Scotland, with some of the policy’s associated costs already baked into the Welsh Government budget.

“But there are other factors that could drive up the cost of the policy. The over-65 population in Wales is proportionately a little larger than in Scotland and the over-85 is population expected to grow slightly faster. Higher prevalence of frailty could be another factor that would increase costs.”

The paper also discusses how the Scottish Government had to step in to recompense ‘self-funders’ who had their Attendance Allowance withdrawn by the Department for Work and Pensions after the policy was implemented in Scotland. According to the researchers, this strengthens the case in favour of devolving this benefit prior to the introduction of free personal care in Wales.

Cian Siôn added:

“Even before the pandemic, the long-term cost pressures of providing social care for an aging population were widely recognised. Sustained demand for personal protective equipment and reduced occupancy in care homes could drive up the unit cost of care even further.

“A national conversation about how to ensure the sector is properly resourced must coincide with a discussion about how people pay for care. Free Personal Care represents one way of reforming the current arrangements and should be weighed up as an option.

“In normal times, the additional budget required to implement this policy would be a significant ask, and for it to be feasible, it would need to be a top budget priority. The impact of Covid-19 on public finances will make choices about priorities more difficult; but finding a way forward on the future financing of social care will continue to be an imperative.”