The Nuffield Trust's response to the Barker Commission Report

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Responding to the final report of the Barker Commission into the funding of health and social care, Nuffield Trust Chief Executive Nigel Edwards said:

“This impressive and clearly argued report clearly sets out a new vision for the stubborn problem of how to adequately fund health and social care for the future, and is to be warmly welcomed.

“Dame Kate Barker and her commissioners have drawn on the real experiences of families caught in the illogical and unfair system at present, in which some people with very acute needs have all their social care paid for by the NHS while others with similar needs have to meet large bills on their own. The commission’s report sets out a credible argument for ending this and providing more equal support for equal need by extending free care to the most vulnerable, expanding this as the economy recovers.  

“But as we don’t know how many people with critical care needs are currently paying for their own care or receiving it informally, there is a risk that the Commission’s central proposal may result in new battlegrounds emerging if numbers eligible exceed the budget available for free care. This will require careful consideration from policymakers and commissioners if it is not to undermine the proposal.

It is now imperative that the forthcoming election campaign does not lead politicians to shy away from addressing the difficult moral issues and challenging solutions proposed by Kate Barker and her commissioners.

Nigel Edwards, Chief Executive, Nuffield Trust

“The Commission acknowledges that funding this will mean making some hard choices, and sets out a range of ways of paying for extended social care. Their suggestion to overhaul prescription charges has merit, provided it does not deter those who are the heaviest users of medicines from accessing their medication. It is also logical to target older age groups more broadly as a source of funding increases on the grounds of fairness, and the Commission’s proposals on winter fuel allowances and TV licenses echo those made by the Nuffield Trust previously.

"However, any measures that remove benefits from older people or tap into other sources of wealth amongst this age group will not be popular. There is still very limited public awareness of just how expensive intensive personal care can be, whether delivered at home or in an institution, and just how many families are exposed to the risk of paying for it out of their own resources under the current system. The proposals contained in this report are based on the argument that society should collectively meet those risks, just as they do for serious health problems.  

“It is now imperative that the forthcoming election campaign does not lead politicians to shy away from addressing the difficult moral issues and challenging solutions proposed by Kate Barker and her commissioners.”

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