The cost of providing long-term care for the elderly could soar by the middle of this century, experts warn.
Some people may be missing out
The Joseph Rowntree Foundation estimates the bill will rise from £12.9bn in 2000 to £53.9bn by 2051.
This is based on a government prediction that the number of people over 65 will grow from 9.3m to 16.8m over the same period.
The number of people aged over-85 - who are most likely to need care - is likely to nearly quadruple to 4m
The Joseph Rowntree Foundation estimates that, allowing for expected growth in the economy, this would mean the proportion of GDP spent on care for older people will increase from 1.4% to 1.8%.
The report does concede that the projections could be radically altered by several factors, including improvements in treating disease, and the advent of improved housing for the elderly.
However, Lord Best, JRF director, warned that it was vital that politicians began to address the issue now before it was too late to make a significant impact.
He said: "It is seven years since the Joseph Rowntree Foundation's Inquiry into Paying for Long-term Care highlighted the implications for care services as life
expectancy increases and those who were born during the post-war 'baby-boom'
reach old age.
"These new projections show that the major problems our inquiry anticipated as demand for nursing, residential and home care increases have intensified.
"The potential for a four-fold increase in spending identified by this report should make politicians and policy-makers stop and think carefully.
"We all need to consider what changes could be implemented now if we are to ensure that people now in their thirties, forties and fifties can be sure of receiving a high standard of care when they need it in old age. It is time to re-open the debate."
Demand for beds
The report also predicts that on current projections, the number of places needed in residential care homes, nursing homes and hospitals will rise from 450,000 to 1.13m by 2051.
It also predicts that the time spent by home care services caring for older people in their own homes would increase from 2m to more than 4.8m hours a week.
State spending on long-term care would increase from £8.8bn to £35.4bn by 2051 under their projections - with the remainder funded privately.
But if England, Wales and Northern Ireland followed the lead of the devolved Scottish executive in funding personal care as well as nursing care, this figure
would rise further to £42.6bn.
A Department of Health spokesman said: "By 2007/2008, the health and social care budget is set to rise to more than £90bn to take into account the rise in the number of older people and the need to more services.
"The report is based on an assumption that rising dependency rates will result in increased costs.
He said government policy was aimed at helping people stay healthy and independent for longer so they can remain at home for as long as possible.
"We know baby boomers are much less likely than previous generations to choose or accept that moving to a care home is the only way they can be cared for as they become older and more frail.
"We are developing and implementing policy that will enable people to make wider choices about how they are cared for in the future, for example, through direct payments, adult placements and extra care housing."
Shadow Health Spokesman Simon Burns said: "The government's handling of long term care is a tragedy of errors. Care homes and beds are being lost at record rates.
"What we need is a long hard look at the way forward to ensure dignity in old age for some of the most vulnerable in our society."