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Your NHS Sunday, 28 February, 1999, 06:18 GMT
Give elderly 'fair deal'
The number of elderly people will rise dramatically in the next century
Charities are calling for a fair, practical and affordable way of funding care for the growing number of elderly people.

They want the Royal Commission on Long-Term Care to ensure people do not find themselves without the funds to support the care they need in old age.

The Commission is about to unveil its recommendations on how the UK should organise and pay for long-term care for elderly people into the next century.

The number of elderly people is set to soar and some scientists are predicting medical advances could mean people could live to 130 in the new millenium.

The King's Fund says the number of old people will rise gradually until 2011, but will then shoot up until 2031 when the post World War Two baby boomers reach retirement age.

The numbers are then expected to stay more or less level. Many will be single because of the rising number of divorces and separations.

The changes mean there will a dwindling number of working people to support the elderly through taxes.

Insurance scheme

Many charities for elderly people support a form of national insurance to fund elderly care.

This would ensure people on low incomes would not miss out on care when they get old.

Leaked reports suggest the commission will favour a compulsory private insurance system which could cost workers around 100 a year.

But charities say this would be unfair for those on low incomes or work on short-term contracts.

Counsel and Care says it would not have to be state-run, but would protect people from the "unpredictable" costs of elderly care.

Other leaks from the commission have put a heavy emphasis on nursing care.

One report suggested the commission was likely to favour a system where nursing care was provided free of charge and living costs were means-tested.

This is estimated to cost around 1bn a year.

Breaking a leg

Les Bryant of Counsel and Care says he fears there may be too much emphasis on nursing care, which is delivered free of charge by the NHS.

Local authority residential care is means-tested.

Mr Bryant says people in residential care and receiving home help may also be very frail and need support.

Many elderly people live at home, but need support
He believes elderly people in nursing and residential care should pay for their board and lodging, but neither should have to pay for care costs.

"People in residential care may need help getting out of bed, washing or eating. They are not sprightly people who can nip down to the pub for a game of darts," he said.

If the commission proposes to broaden the "artificial divide" between nursing and residential care, he says, it could end up with elderly people "breaking a leg" to get into a nursing home in order to save some money.

A large number of frail elderly people live at home with support being provided by community nurses or local authorities.

Local authorities often charge for services and, because of cuts in funding, the charges have gone up over recent years or services have been cut back so that only the most vulnerable receive them.

"The charges vary widely. It is a postcode lottery," said Mr Bryant.

Tackling the care lottery

Most elderly charities support Mr Bryant's views and argue that there should be national eligibility criteria for care.

Help the Aged says the current system has suffered from competing pressures, mainly concerns about the cost of funding care.

Independent and private care providers say local authorities have often provided their own services despite the fact that they are not the cheapest or most effective.

Barry Hartley, chairman of the National Care Homes Association, said: "The days should be long gone when expensive services provided by councils are still being purchased when the same quality services can be provided more cost effectively by the private and voluntary sectors."

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15 Jul 99 | Your NHS
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