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Thursday, July 15, 1999 Published at 18:09 GMT 19:09 UK

UK Politics

The politics of long-term care

The report's plans could cost the state £800m

The government has yet to respond to the main recommendations of a major study into caring for the elderly.

Four months after the Royal Commission on Long-Term Care for the Elderly called for free nursing and personal care to be available for all, there is still silence from ministers.

The commission was set up by the government to look into the complex issue of who funds long-term care.

The motivation was concerns over Britain's ageing population.

Currently, the ratio of people of working age to people over 65 is 3.7 to one.

In the next 40 years that is likely to fall to two to one, meaning there is less tax money around for the government to fund long-term care.


The commission's key recommendations include:

  • That the costs of care for those individuals who need it should be split between living costs, housing costs and personal care
  • That personal care should be free and funded by general taxation
  • That elderly people should pay for housing and accommodation costs, but that payment should be subject to a means test
  • That the government should establish a National Care Commission to monitor trends in the nursing and residential care market, demography and spending, to represent elderly people, to encourage innovation, to ensure transparency and accountability in the system and to set national benchmarks for long-term care.

The commission also recommended that the value of a person's home should be disregarded for up to three months after admission to residential care.

It stated that quality of care needed to be improved so that it was more client-centred and that budgets should be shared between health, social services and other statutory bodies, but accessed by clients through a single point of contact.

The commission also made recommendations relating to carers and called for a national carer support package.

Selling homes

Under the current system, people who are in care homes run by the NHS are exempt from charges for nursing care, while those in other types of homes often have to contribute towards their care costs, based on means-testing.

[ image: The growing elderly population will need long-term care]
The growing elderly population will need long-term care
People with between £10,000 and £16,000 in savings get some help from the state to pay for their care.

Those with under £10,000 get the maximum state support, but are still expected to use their savings to pay towards some of their care.

The commission recommends that level should be raised to £60,000.

Many elderly people have been forced to sell their homes to pay for long-term care.

Nursing organisations and charities campaigning for the elderly have long oppposed what they say is an arbitrary division between nursing and personal care.

The cost of funding the commission's proposals over funding personal care is thought to be about £220m a year.

Unveiling the commission's report in the House of Commons in March, Health Secretary Frank Dobson said the government would respond after an informed debate, but no formal response has yet been issued.

The Commons health select committee has criticised the government for its lack of response.

On Thursday, the government responded to the select committee's report on long-term care, saying it backed many of its findings.

However, it was once again silent over the committee's comments on the Long-Term Care Commission.

Charities have also been critical of the delay.

They have welcomed the commission's proposals, but some organisations are disappointed that it did not endorse concerns about a "demographic timebomb".

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Internet Links

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Department of Health

Long-Term Care

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