The economic value of the support to older persons in South Africa has grown. However, it has not been increased sufficiently to meet the needs of a growing older population, nor has it been adequately linked to inflation, a report released on Sunday by UCT’s Family Caregiving Programme (FCP) has found.
The “Funding Elder Care in South Africa Report” outlines how state funding for older persons is structured. It shows that over the last two decades, spending on older persons in South Africa has been focused on social grants, most notably the Older Persons Grant.
“The authors note that whilst this can be applauded, it tends to overshadow the lack of state spending on programme and policy support and transfers paid to non-profit organisations (NPOs) that provide residential care or community-based services to older people.
“The population of older persons in South Africa has increased from approximately 3.4 million people in 2006 to 5.6 million people in 2022,” read the report
Principal investigator Associate Professor Elena Moore said that examining the change in funding over time, they found that the funding at provincial levels had decreased by 13%.
“The Department of Social Development (DSD) is not prioritising community care in terms of the number of people who can access care services and the amount of support they receive,” said Moore.
Moore said the spending per person adjusted for inflation is 5% higher in 2022/2023 than 2006/2007 but provincial funding is down 13% since 2006/2007. In 2022/2023 the total DSD budget spent for older persons was just over R93.89 billion, 5% more in real terms than in 2006/2007. While national funding is up 5%, provincial funding is down 13%, so the combined national and provincial support from DSD in 2022/23 is up by 4%.
The report further said that looking at an 18-year period, the authors note that funding hasn’t returned to pre-Covid-19 amounts both in terms of total levels and adjusted per person.
Spending on older persons in South Africa is focused on the Older Persons Grant, which reaches 3.8 million older persons.
“This amount represents approximately 98% of all DSD’s spending on older persons. The rise in the number of older persons has led to an increase in the economic cost of the older persons’ grant.
“The remaining 2% of funding is spent on programme and policy support and development at a cost of R19 million in 2022/2023 as well as subsidies and transfers paid to NPOs that provide residential care or community-based services to older people at a cost of just over R1.5bn,” added the report.
The current structure of community support reaches about 100 000 older persons nationally.
“However, the authors calculate that over 1.5 million people or 40% of the older persons population require support with daily activities. State care provision is not reaching older persons due to either the inability to attend a service centre, due to mobility issues or because there is no service centre in their area, or they are not ‘frail enough’ to be eligible for residential care.
“The Older Persons Act (2006) emphasises family- and community-based care. Yet state funding is not prioritising community care despite the policy focus on supporting community-and family-based care,” read the report.
The report said there is very little funding allocated to NPOs that provide services to older people and their caregivers at the community level.
“Funding has also decreased over time. Essentially the focus on state support for older persons is on social grants and subsidising the cost of care to the very frail and the very poor. This means that there is a decrease in spending at the community and family level at a time when the older person population is growing, leaving large proportions of the older person population receiving little, if any, community-based care,” added the report.