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Fabians reveal £10 billion black-hole in support for older people

New research launched ahead of Fabian summit on the future of support and care for older people



A £10 billion shortfall in spending for older people in England is revealed today in new research from the Fabian Society – and the figure will soar over the next decade as needs rise fast.

The findings come ahead of a Fabian Society summit on Monday 19th March to debate the left’s policy answers for older people with support needs, where the shadow cabinet minister for care, Barbara Keeley MP will make a keynote speech.

Unmet needs today

For the first time the Fabian Society analysis looks in the round at the £25 billion of spending designed to help older people with support needs across social security, housing, social care and health services. It reveals under-funding that goes far wider than just council-funded social services.

Read the research

The £10 billion figure is built up from service-by-service estimates, following a detailed review of the evidence and projections published in recent years. The figure is based on existing means-testing rules:

  • £5 billion – the cost of providing support to 1.2 million low/mid-income older people who aren’t receiving help with essential daily tasks including washing, dressing and eating.
  • £1.5 billion – the extra spending needed for NHS rehabilitation services to support all older people who could benefit
  • £1.3 billion – the cost of adequately funding council-paid care home places, to stop unfair cross-subsidies and top-up charges
  • £1.2 billion – a cautious estimate of the price-tag to tackle isolation and step in early to prevent needs arising
  • £0.9 billion – a cautious estimate of the extra annual spending needed to bring the supply of specialist older people’s housing more into line with other countries

Rising demand in the future

The Fabian research also reveals huge extra demand for spending in the future as the number of disabled older people increases and costs per person rise faster than inflation. This is the first time projections for rising spending on disabled older people have been combined across different forms of support (all figures in 2017/18 prices):

  • Spending will need to rise to around £40bn by 2030 to provide the same (inadequate) level of support that is available today. This is an increase from 1.4 per cent of GDP today to 1.8 per cent in 2030 (equivalent to a tax rise of £7bn today).
  • Spending will need to rise to around £60bn by 2030 to meet existing unmet needs and to respond to rising demand and costs per person. This is an increase to 2.8 per cent of GDP in 2030 (equivalent to a tax rise of £24 billion today).

These projections are on the basis that social care remains means-tested. More generous support for wealthier older people would add to the costs – or might be funded instead of responding to all the unmet needs identified.

Fabian Society summit looks to solutions

The research is being presented to a summit of Labour politicians, experts and charity leaders taking place on Monday 19th October. The event will examine how a future government should respond to the challenges of rising disability in old age.

With many of Labour’s policies for disabled older people dating back to the 2010 and 2015 elections, the summit is a fresh opportunity to consider the left’s response to our ageing society. Barbara Keely MP (shadow cabinet minister for social care and mental health) will make a keynote speech including announcements of new Labour policy.

The event is organised by the Fabian Society in partnership with Age UK and Hanover Housing Association. Organisations taking part include the Alzheimer’s Society, British Geriatrics Society, the Centre for Ageing Better, the Health Foundation, Housing and Care 21, Independent Age, the King’s Fund and Unison as well as senior figures from local government.

Fabian Society comment

Andrew Harrop, general secretary of the Fabian Society said:

“As a country we need to spend billions more each year to support frail pensioners both because the number of people who need care is rising so fast and because the help on offer today is so inadequate.

“Labour can lead on this agenda because it is the only party with the courage to say that big spending increases will be essential each and every year. The party needs to explain where the money is coming from, but with a clear new offer it can convince the public that only Labour will provide the support and dignity older people deserve.

“After the 2017 election the Labour party knows it needs to regain the trust of older voters and making a credible promise on support and care will help it do that. Promising to spend more on help for frail pensioners is true to the party’s values and it is what people want and expect.”

Read the research

Data tables from the research

1. Estimated extra spending required to fully meet the needs of older people today, current financial entitlements (England, 2017/18 prices)

£ Billion % of GDP
Social care: assessment and other services £1.2 0.1%
Social care: care homes £1.3 0.1%
Social care: home care £5.0 0.3%
Supported housing £0.9 0.1%
Equipment and adaptations (all ages) £0.1 0.0%
NHS intermediate care £1.5 0.1%
TOTAL £10.0 0.6%


2. Scenarios for public spending on older people with support needs in 2030, current financial entitlements (England, 2017/18 prices)

Respond to rising demand Respond to rising demand AND today’s unmet need
£ Billion % of GDP £ Billion % of GDP
Social care: assessment and other services £2.2 0.1% £4.4 0.2%
Social care: care homes £5.7 0.3% £8.0 0.4%
Social care: home care £6.2 0.3% £17.6 0.8%
Supported housing £3.3 0.1% £5.4 0.2%
Equipment and adaptations (all ages) £0.8 0.0% £0.9 0.0%
NHS continuing care (all ages) £7.6 0.3% £7.6 0.3%
NHS free nursing care (all ages) £1.0 0.0% £1.0 0.0%
NHS intermediate care £3.0 0.1% £6.0 0.3%
Disability benefits £10.5 0.5% £12.5 0.6%
TOTAL £40.4 1.8% £63.5 2.8%

Note: spending today in England is £24.8 billion (1.4 per cent of GDP)

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