Meeting the costs of disability and care needs in later life
For many years, researchers within the Health Economics Group at UEA have conducted research which aims to sharpen policy judgements on reform of care services funding and disability benefits for older disabled people, in the face of population ageing. Our work has focussed on how potential reforms to the current systems of disability benefits paid from the social security budget and state support for the costs of care, paid via Local Authorities, would be felt across income groups and other socio-economic categories. It applies econometric and microsimulation techniques to micro-data, typically from major household surveys, to understand the personal costs that disability brings in later life and to examine the distributional effects of potential reforms to disability benefits and social care funding for older people.
Much of our research has involved collaborations with, for example: the Personal Social Services Research Unit at the London School of Economic; the Institute for Social and Economic Research at Essex University; the Health Economics and Decision Science section of the School of Health and Related Research at Sheffield University; and the Pensions Policy Institute.
Our track record of research and policy impact underpins our partnership in the ESRC Business and Local Government Data Research Centre. This is allowing us to use different forms of data to bring evidence on local variations in the impact of national policy on care and support for older people, to the continuing national and international policy debate on how to meet the costs of disability and care needs in later life.
Policy engagement and impact
Over the years, there have been various suggestions that public funds channelled through disability benefits for older people (Attendance Allowance (AA) and Disability Living Allowance (DLA)/Personal Independence Payment (PIP) should be redirected to the care system. The premise for these suggestions has often been that because disability benefits are not means tested, whereas subsidised social care is, the former are poorly targeted on those in most need. Our research has demonstrated that disability benefits for older people are in fact well targeted on those who can least afford the costs that disability brings in later life. These findings underpinned written evidence that we provided to a 2009/10 House of Commons Health Select Committee Inquiry into Social Care which was quoted widely in their report. The 2010 Social Care White Paper ruled out at least for the next Parliament, any reform of AA and DLA to fund its proposed reform of social care.
In 2016, the Government consulted on whether to devolve responsibility for AA to Local Authorities (“localisation of AA). A report we wrote as part of the Joseph Rowntree Foundation’s anti-poverty strategy, and a paper by the Strategic Society Centre which drew heavily on our research, were both quoted extensively in a House of Commons Library publication on the background to the consultation and to its final conclusion – in January 2017 the Secretary of State for Communities and Local Government announced that the Government would not be devolving AA to Local Authorities.
In December 2016 we published analysis of the distributional effects of saving money on state pensions by uprating them by less than the ‘triple lock’ and using some of the savings within the care and disability benefits system. During the 2017 election campaign, Theresa May indicated that she was considering less generous state pension uprating to release funds for social care.
More recently we submitted written evidence on long-term care funding options and on fairness and targeting of public support for older people with disabilities to a 2018 joint Inquiry by the Health & Social Care and Housing, Communities & Local Government committees into the long-term funding of adult social care.
Analysis of the effects of recently suggested reforms to the long-term care funding system can be found here.