Care needs as one gets older has become an increasing and important aspect of retirement well being and also an expensive one, with the necessity to sell one’s home to pay for it.
Here again the State does not take the matter seriously, without doing the simple sums to find the costs or properly assessing the needs to establish what is affordable and the best way of meeting it. As a result the improvident flourish and are looked after by the taxpayer and the prudent are left to fend for themselves.
Of course what has this to do with pensions you may well ask? Only that self-sufficiency and pension savings could offer the funds, income and method to provide a real and long term solution, with the State offering the medical care and welfare aspects.
Care in old age should be separated into dependency regions ranging from full hospital needs down to the minimum social contact and activity requirement of old people living alone. At present it is all or nothing with charitable groups trying to supplement the nothing, but care could be phased in more effectively.
In general, needs increase from age 75, possibly earlier with someone living alone, social contact and activity the main ones and these were provided by luncheon clubs etc, which unfortunately have been steadily reducing over many years due to spending cuts. A false economy.
Sheltered housing meets the next phase where a warden or live-in couple keep an eye on residents, with communal recreation rooms, guest bedrooms, and possibly meals supplied and this can extend over a long period and for some all that is necessary.
Residential homes are next, where intermittent medical care and help become necessary, usually with a resident nurse and doctor on call and then finally hospice or hospital care., which is the expensive stage.
Cost steadily increase as you go up the chain and this is made worse by stringent regulations, often resulting from odd incidents, specifying staff patient ratios, 24 hour and medical attendance etc., all of which become unaffordable.
This is made worse by commercial exploitation, as witnessed in recent events, where homes are bought or transferred to a management company and then leased back at high rents and maintenance charges, similar to the situation in PFI for hospitals and schools.
Pension funds could offer investment funds at reasonable rates to meet property needs and could generate sufficient funds to meet costs at the high dependency end. The lower levels need greater planning and use of resources.
There are a large number of experienced unemployed, housewives and early retired who would welcome part time work running day centres and organising activities. There are also a large number of halls, leisure and recreational facilities and even pubs and hotels that are under-utilised which could be readily organised for meetings and daily outings.
How to pay for it is the next question; at the intensive care end, the State must be responsible, but could assist and save itself money by supporting charities and part time wage bills. Management charges in retirement apartments range from £1- £3,000 pa outside London, depending on level of service, partly offset by reductions in personal insurance and maintenance costs.
Many hotels, who meet fire and other regulations, offer short breaks as low as £20 per night half board with good staff and back up services, so it should not be unreasonable for minimum residential care centres to start around this level, increasing with level of care. This may require changes to different homes or wings as conditions deteriorate. Minimising upset where possible.
A review of numbers and needs would be required, but this is in any event overdue, together with a common sense approach to regulations. State estimates of cost suggest individual payments of £20,000 and annual expenditure increases of £2-3bn, which is a small part of current pension costs and fund values.
Savings Annuities Public Sector NHS Teachers Police Local Government Hutton State
No comments:
Post a Comment