By Sue Littlemore
Social affairs correspondent, BBC News
Within 20 years a quarter of the adult population will be over 65
Ministers are warning that England's social care system is heading towards a £6bn funding gap unless there is radical reform, the BBC has learned.
Health experts predict the ageing population means state funding for the care of the elderly and disabled will face a huge shortfall within 20 years.
The warnings come as ministers are about to begin a major consultation on how social care is funded.
Currently, most people in England have to pay for home help themselves.
State support is means-tested and most people have to pay for any home help, including washing, dressing, cooking, themselves.
Health ministers say they are aware of a widespread feeling that this system is unfair.
Also, rapidly growing demand means social care is already being heavily rationed and ministers predict that is set to worsen.
Paul Cheesman on the social care he receives
Within 20 years a quarter of the adult population will be over 65 and the numbers over 85 will have doubled.
It is expected over two million extra people will need care by the middle of the century.
But state funding for social care currently grows at a much slower rate than the population explosion among older people demands.
This means we are heading for a funding gap of £6bn within two decades unless the system is changed.
This is one of the greatest challenges facing not only government but families and society in general
Care services minister Ivan Lewis
And that is what ministers have promised to do. They believe a new care system for the 21st century is needed and say they want a radical rethink.
On Monday, they will start a public consultation asking how the state, families and taxpayers should share the costs of this increasingly important service.
Care services minister Ivan Lewis insists there are no easy answers.
He told BBC News: "This is one of the greatest challenges facing not only government but families and society in general.
"Together we have to decide what quality and level of care services we have a right to expect in a civilised society.
"And what we need is to move towards a system which is fairer; where people feel it's fair in terms of what is expected of them and also in terms of what the government can pay and what is affordable."
Liberal Democrat health spokesman Norman Lamb said the cost of social care had to be shared between individuals and the state.
"We had previously argued for free personal care but any policy you come up with has to be sustainable," he said.
"We would inject an extra £2bn into care for elderly people and use that as a mechanism to increase the quality of care for people and to scrap this pernicious means-tested system."
The government consultation will last six months and include a number of so-called listening events around England where people interested in modernising the social care system can share their views.
Eventually the government will set out proposals for reform in a Green Paper.
One option certain to be ruled out is making social care free.
It happens in Scotland, but proved so costly there has been rationing.
Another option not on the table is the status quo - everyone seems clear, when it comes to caring for the elderly and disabled, things cannot go on as they are.
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