Social Care: Who should pay, other than those who benefit?

Guest post by Dr Wesley Key

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When Boris Johnson became Prime Minister in July 2019, he promised from outside 10 Downing Street that “we will fix the crisis in social care once and for all.” With his premiership since being dominated by Brexit and then Covid-19, little has since been heard about how this may be achieved, but reports in July 2021 suggest that a rise in the basic rate of income tax or in National Insurance Contributions (NICs) is being considered in order to increase Social Care funding for England. Such a move would break a Conservative manifesto pledge and would also be highly contentious in terms of intergenerational fairness.

Other potential options put forward to help to fund Social Care (and other public services) in England have included: An extra tax on people aged 40-plus (similar to the system in Japan), levying NICs on private pension income, reducing tax relief on pension contributions (to a maximum of 20% for higher rate taxpayers), raising the Upper Earnings Limit (UEL) for NICs, and making workers over state retirement pension age liable to pay NICs at the same rate (or a reduced rate) as ‘working age’ employees. Work by the IFS in 2018 implied that NICs paid by workers over state pension age could potentially raise £1-1.5 billion annually, not accounting for the behavioural changes that such a policy would inevitably lead to. Regardless of the amount of revenue raised, such a system would be morally justifiable in terms of: Older workers losing their current privileged position within the personal taxation system; older people who are sufficiently healthy to carry on paid employment helping to fund the social care needs of others in their birth cohort who are in poorer health (perhaps due to working in more physically demanding job roles earlier in life).

Whilst this reform would see the national insurance system return closer to its Beveridgean roots (Beveridge did not intend that NICs were solely a way of accumulating state pension entitlement), it would be insufficient to properly fund a Social Care system that included a lifetime cap on care costs along the lines of that proposed in the Dilnot Report on Social Care: Commission on Funding of Care and Support, 2011. It is therefore also recommended that the UEL for National Insurance contributions is significantly increased, along with the NICs rate for earnings above the UEL, as it is iniquitous that, in 2021-22, earnings over £967 a week are liable to just 2% NICs, compared to 12% NICs paid on earnings of £184-967 a week.  

By reforming National Insurance in the above ways, this could help to better fund England’s creaking Social Care system, potentially enabling a lifetime care costs cap to be introduced, and without raising taxes on employees aged under 66 who earn less than £50,000 per year. Such an approach would be compatible with Boris Johnson’s 2019 pledge to ‘fix’ social care and with retaining his expanded support base among lower paid working age people across the Midlands and Northern England. It would also be justified in terms of intergenerational fairness in a period when government spending on pensioners has risen by more than spending on younger age groups.

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