The government has published a Green Paper which sets out plans for a major overhaul of the current means-tested system of providing social care for the elderly and chronic sick.
Given the projected massive increase in the numbers of people living well beyond 75 over the next 30 years the existing system is seen as unfair and unsustainable.
Social care covers everything from home help with washing and dressing through to full-time residential care. At the moment, anyone with a home or savings of £23,500 or more is not given any state funding for their care.
About three quarters of people in the system fall into this category. This means that thousands of pensioners each year have to sell their homes or use their savings to fund their long-term care.
Experts predict the situation is only going to get worse in time with the ageing population.
The Green Paper proposes three options for funding a new National Care Service:
- A ‘partnership’ approach, under which the state would pay around a quarter to a third of the cost of basic social care and support, leaving individuals to find the remainder;
- A voluntary insurance scheme, under which the state would pay the same proportion, but would also make it easier for individuals to take out insurance - at an estimated cost of around £20,000 to £25,000 at today's prices - to cover the rest;
- Compulsory insurance for all, costing around £17,000 to £20,000 at today's prices and providing free care for all who need it.
The National Care Service would offer assistance with needs like dressing, washing and moving around at home, but individuals who need to go into residential care would continue to pay the cost of accommodation and food themselves, whether they had taken out insurance or not.
But Professor Chris Drinkwater, president, of the NHS Alliance, described the proposals as "silo thinking and a missed opportunity to develop a more imaginative approach".
He said costs to the exchequer of health care for people over 65 are more significant than the costs of care services.
"Establishing a National Care Service in parallel with the NHS runs the risk of creating a barrier to joint working.
"While the NHS Alliance would not want to undermine the principle of health care free at the point of delivery, we believe that an opportunity has been missed to look at pooling health and social care budget for people over 65 as well as joint commissioning of services between local authorities and primary care trust through practice-based commissioning clusters.
"The focus of this paper is inevitably on the options for paying for care services. The NHS Alliance favours the partnership model, with the option for people to cover additional costs through insurance should they wish."
The Local Government information Unit welcomed the fact that the Green Paper took on many of the recommendations made last year in its report Never Too Late for Living.
Chief executive Andy Sawford, commented: ‘‘There is a really important balance to be struck though between the perceived 'guarantee' that a national system offers, and the reality of local variance. Local variance can be a beneficial part of the system if it is about local innovation and meeting particular local needs. The green paper makes a welcome proposal to join up services for older people but in line with this it is vital that there is a radical shift in funding and greater flexibility in commissioning services at the local level.
"What is also important is that in trying to establish a solution to the long-term problem of funding social care, we have to recognise that our system is also currently facing a crisis. Proposals in the green paper could take some time to implement and therefore we also need to urgently address how we will provide care for older people now."