Many people get a real shock when they or a relative develop needs for care and support, because they expect that care to be free at the point of access, just like the NHS.
But after the Second World War, the two systems – health and social care – were set up as two separately funded services.
Unlike the NHS, in order to access publicly funded social care your needs have got to meet certain criteria; they’ve got to be high enough. In order to access publicly funded social care, your means also have to be low enough. If you have more than a relatively small amount of savings and assets, you will have to pay for some – or all – of your care.
Many people who don’t qualify for publicly funded social care end up paying for it out of their own pocket. Although it’s hard to estimate exactly how much private funding there is, some estimates put it at half of all expenditure.
Social care is funded by people who pay for their own care, by local government, and in many cases a mixture of the two. Councils are still the biggest single purchaser of care services; the money they choose to spend in each area is drawn from a mixture of central government grants, council tax, user charges, business rates, and contributions from the NHS.
Since 2010, councils have had to deal with cuts in government funding. Although the government have introduced short-term measures to help councils pay for social care over the next few years, long-term changes are needed in the way that we pay for care.
The impact of a growing older population and increasing needs means there's real pressure on social care now. This is one of the most difficult policy challenges of our times, and it will take more than just one parliament to overcome it.
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