Stepping-Stones: A strategy for reforming long-term care funding

Stepping Stones A strategy for reforming long-term care funding

A think-piece looking at how reform of long-term care funding should be framed by policymakers and stakeholders, and what this means for how reform can unfold.

This report has been made possible by the support of the Nuffield Foundation.

Debate on how to fund older people’s long-term care has tended to emphasise a simplistic menu of options, resulting in polarised positions among political parties, and preventing reform from getting under way. But the outcomes required of long-term care funding reform represent not one reform, but many, which vary in their complexity and the political sensitivities they may incur. Framing reform as a series of ‘stepping-stones’ reveals how many of the stumbling blocks to reform can be overcome, for example: the transition to a national assessment and entitlement framework; staged evolution in the shape of the state safety-net; and, a gradual transition from voluntary to compulsory contributions.

This think-piece is therefore not about how long-term care in England and Wales should be funded, but rather, about how reform should be framed and implemented, i.e. what the strategy for reform should be.

The analysis in this report shows how: widely different models of long-term care funding require some of the same policy changes and structural reforms to be made; seemingly large and challenging reforms can be broken down to a series of manageable steps; and, few models of long-term care funding have to represent fixed endpoints and can themselves be implemented and developed as stepping-stones in a longer process.

The report argues that such analysis suggests the need for a ‘stepping-stones’ strategy for reform which: prioritises shared steps required by different funding models; evaluates individual funding models as stepping-stones, not just as end-points; and, proceeds immediately in areas where consensus exists.

Author: James Lloyd, Strategic Society Centre

Download the report: Stepping-Stones – A strategy for long-term care funding reform

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