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Options for future funding of nursing and residential care

Monday, 9 July 2018

Options to reform the future funding of nursing and residential care in the Isle of Man are set out in a report to be considered by Tynwald.

The Isle of Man Government is working towards putting in place a fair and sustainable system against a backdrop of an ageing population with increasing life expectancy.

The ‘options and next steps’ report highlights a range of potential models aimed at addressing what is described as a massive issue for the Island.

Chris Thomas MHK, Chair of the Social Policy and Children’s Committee, is heading the Political Project Board overseeing the work taking place to identify the best approach. Further progress in this area will be coordinated with actions from the independent review of the Island’s healthcare system being led by Sir Jonathan Michael.

While health care is a universal service, free for all at the point of need, social care is not. The report points to a feeling among Island residents of a lack of fairness in the use of a person’s capital and assets to pay for care. There is also a strong perceived right to inherit in the Isle of Man.

Work has been taking place across Government and in partnership with public focus groups and care providers to raise awareness of the issues and to bust some common myths and misconceptions.

Mr Thomas said:

‘Ideas about how to fund important elements of social care need to be translated into deliverable reform and fairer provision. This report on the future of nursing and residential care identifies policy options, considers their relative merits and lays out the next steps for what is a massive and complex issue.’

He added:

‘Many people have voiced concern about the costs they may incur paying for care in later life. Successful reform of the funding of nursing and residential care will require agreement about the balance of responsibility between the state and the individual and a consensus between those who are asset-richer and asset-poorer about what is fair. It is a complex challenge, but there is an appetite for change.’

Six possible options, including their advantages and disadvantages, outlined in the report are:

  • Modified Manx offer
  • Threshold and Cap schemes
  • Asset Protection Guarantee
  • Free personal care (Scottish Model)
  • Hypothecated Tax/Social Insurance Model
  • Mixed (Jersey Model)

It is recommended that detailed modelling of a new system for the Isle of Man will be carried out based on the Jersey and Asset Protection Guarantee models, subject to the Tynwald debate. A report on progress will be made in July 2019 following fuller public engagement and parallel investigations.

The report on nursing and residential care links to the development of other policies to deal with an ageing population, with the number of over 65s in the Isle of Man set to increase by 30% by 2036 – from 17,000 to 22,500.

Work is also continuing to promote early healthcare intervention to help prevent longer-term reliance on residential nursing care and to deliver integrated health and care services to enable people to live safe and well at home for longer.

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