Leading Article: Care for the sick and elderly is a key test of civilisation

NEIL KINNOCK famously warned people not to grow old or sick under a Conservative government. Two years into New Labour's regime, things don't seem to have got much better. Yesterday's landmark ruling by the Court of Appeal on long-term care will have kept thousands of pensioners lying awake at night, worrying about losing their houses and life savings.

However, the wretchedness of old age is not just the fault of successive governments - it is the fault of the whole of society. Many people see the care of the sick and the elderly as the key test of civilisation. But what if this focus on care is itself part of the problem?

Old people are seen as victims in need of care, rather than people who need fulfilling lives. Spurred on by pessimistic (and probably wrong) projections for growing numbers of elderly people, we debate how to pay for their long-term care rather than working out ways to keep people healthy and wealthy enough to fend for themselves. This is fatalistic. The fact that there will be more elderly people doesn't necessarily mean more people in care - if we get our policies right.

Medical research shows that keeping active is the best way to stay out of care. People who eat good food, lead busy lives and have large networks of friends tend to stay healthy. On the other hand, staying at home alone, glued to the television set and eating bad food, is a fast track to morbidity.

The irony is that our society is in danger of smothering the life out of its senior citizens by offering them unwanted care rather than a chance to fulfil themselves. The struggle to pay for places in residential homes is, in fact, driving cash-strapped local authorities to cut back on the very things that can offer the elderly independence. Lunch clubs, dial- a-ride services and transport to libraries - the things that get people out of their homes and allow them to stretch themselves - are replaced with the solitary confinement of meals on wheels, home visits and residential care.

But the biggest problem is a retirement age that was devised by Count Otto von Bismarck at a time when few people expected to live beyond 65. Today it is a needless restriction, forcing people out of work and into their homes when they have energy and experience that could make a real contribution to society.

The key to cutting the costs of long-term care will not come from ever stricter means tests. It will come from measures to tackle low incomes, poor housing, unhealthy diets, inadequate heating, social isolation, and poor access to affordable transport - in short, all the things that stop the elderly from being busy and healthy. For local authorities, this will mean less care in the community and more activity in the community. It could mean promoting education, such as the successful University for the Third Age. The role played by carers in the home is also significant; they must be given more support, both financial and practical.

It is time to retire the compulsory retirement age. Instead of a one- size-fits-all date and "old-age pension", we should investigate new forms of insurance that allow people to take time out of their working lives and work in their old age. Of course, even if we do manage to hold back the years and reduce the need for long-term care, we shan't be able to abolish it altogether. Some elderly people need constant attention at the end of their lives, and there will always be people with disabilities and special needs, such as Pamela Coughlan (who brought the case to the Court of Appeal). Their plight raises some tough questions in the medium term. While the sick and disabled should always have as much state support as possible, we all know that we are going to grow older and, for most people, there is no excuse not to make preparations.

Emotive stories of tearful pensioners losing their houses and hard-earned savings to pay for residential care have led to attacks on means-testing that seems to punish those who have taken the trouble to save. But is it right that those who can afford to pay for themselves should be subsidised by the taxpayer? And who decreed that savings should be earmarked for inheritance rather than paying for old age? These are no longer tenable beliefs in an age of increasing individualism, choice and self-reliance.

In the long run, we shall be able to solve these problems only if we think of old age in a different way. The Government's responsibility should be to enhance our independence rather than turn us into patients. However, we shall also need to prepare for old age with insurance for long-term care as well as with pensions, while banks and building societies will need to provide mortgages for the elderly - which will allow us to cover some of the costs of care. If we begin these reforms now, by the time there is another Tory government it will be safe to grow old and sick.