MPs Vote To Weaken Care Fees Cap

Late last night, the government narrowly won a majority vote to make a small amendment to Article 49 of the Health and Care Bill.  The amendment has been controversial but will now become law and be effective from October 2023.

Care is made up of three elements:

• Health Care:  medical treatment in hospital, at home or in a care home.
• Personal Care: where you need help and support for activities of daily living (ADLs) of a personal nature such as bathing, showering, applying creams and lotions, changing dressings, getting dressed, laundry and toileting and continence.  Again, this can be at home or in a care home.
• Board and Lodgings:  We call this your ‘hotel’ costs.  Clearly, if you live at home, there are no costs but there is a cost if you are in a care home.

What are the rules and the £86,000 Cap?

• Health Care:  medical treatment in hospital, at home or in a care home is funded by the NHS, you do not pay for these.
• Personal Care: There is to be a new means test where if you have assets below £20,000, the state will pay.  Assets between £20,000 and £100,000 you pay some of your personal care costs on a sliding scale.  Assets in excess of £100,000, you will pay in full for personal care costs.  Where you are required to pay, whether in full or the sliding scale, these costs have a lifetime cap of £86,000 and then the state will pay.
• Board and Lodgings:  ‘Hotel’ and food costs are means tested and if you have assets in excess of e.g.£20,000 (currently £23,500), you still pay for your accommodation costs in full.  These costs are not included within the £86,000 cap.

What is the Amendment to Article 49?

In the original bill, the maximum an individual (with assets below £100,000) would pay towards personal care would be capped at £86,000, this included any funding towards these costs paid by the local authority.  This means that many would hit the £86,000 cap earlier with local authority support costs using up some of that cap.

The amendment removed the any local authority support being included towards the £86,000 cap meaning that we must all pay at least £86,000 towards the personal care costs (excluding any local authority support) before the cap ‘kicks’ in.

Many MPs voted against the government change as well as some conservative MPs abstaining from the vote.  The majority dispute that this would hit poorer families and the less financially able the hardest.  E.g. if you have total assets of £100,000, £86,000 care costs would leave just £20,000 (where the mean test limit ends) i.e. 20% of wealth retained by the family but if you have assets worth £400,000, this would leave you with £314,000 i.e. 78.5% of wealth retained by the family.