All older people should be guaranteed basic level of care

The controversial policy of means testing elderly people who need long term care must end, says a new report. Under radical proposals set out by Sir Derek Wanless, the number of people in England required to sell their homes to pay for personal care would be slashed—but at a price.

Sir Derek, who produced the 2002 Treasury report calling for a massive rise in NHS funding, now advocates a near doubling of social care spending over the next 20 years, from 1.1% to 2% of gross domestic product BMJ 2002;324: 998. This would result in a tripling of the budget in cash terms from £10.1bn (€14.5bn;$17.5bn) in 2006 to about £30bn by 2026.

But Sir Derek said that the plans, published in partnership with the King's Fund, would guarantee all elderly people a basic level of care, regardless of their ability to pay. People would still be able to top up the service they receive out of their own pockets—with every £1 they put in matched by an equal contribution from the state. In total, the plans envisage the state paying for 83% of the social care bill.

The state should meet 83% of the social care bill for older people who need long term care

Credit: ALIX/PHANIE/REX

Currently, people with assets of £20 500 or more have to pay their care home fees, forcing many of them to sell their homes. Sir Derek said that the current system meant that only very poor or very dependent people were getting adequate help: “People in moderate need or those in moderate ill health are not getting enough help or support.”

In Scotland free personal care has been provided for older people since July 2002, when Scotland broke away from England's policy of means testing.

Jonathan Ellis, the policy manager at Help the Aged, urged ministers to follow Sir Derek's advice: “This review will serve well to increase already mounting pressure on the government to finally put its money where its mouth is in the delivery of health and social care.

“Doing nothing is not an option. The government can ill afford to stand back and allow older people to continue to suffer a confusing and unfair health and social care system.”

The Department of Health responded by saying that it would set up a task force.