How does the current care system operate, and how can it be improved?

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The Independent Online

Q What is the system at the moment?

AAnyone deemed in need of care – whether at home or a residential centre – is assessed for their personal wealth and the seriousness of their condition. Those who have assets worth more than £23,500, including the value of their home, are liable to meet their care costs.



QAnd why does this system not work?

AThere is simply is not enough money to meet the fast-growing cost of caring for the numbers of people living into their 70s, 80s and beyond. In addition, a "postcode lottery" operates over the provision of services. In some areas people pay out more than £200,000 for their care, while in others they receive it for nothing.

Many councils only provide free care to people assessed as having the highest needs, meaning people who rely on carers for vital help have to pick up the bills themselves.



QHow has the Government responded?

ASlowly and belatedly. It was in 1997 that Tony Blair declared: "I don't want them [children] brought up in a country where the only way pensioners can get long-term care is by selling their home."

A Royal Commission two years later recommended that all personal care should be free. The conclusion was accepted in Scotland, but rejected elsewhere in the UK.

A Government Green Paper last summer proposed the creation of a National Care Service and floated three ways it could be funded. The first would see people and the state sharing the cost; the second envisaged a voluntary insurance scheme; the third would require everyone to pay up to £20,000 into a compulsory scheme, although the payment could be deferred until after death.



QWhat has Labour said on the subject since then?

AGordon Brown surprised last year's Labour conference with a promise to provide free personal care at home for 400,000 of the most disabled adults who are above the means-test limit. He said the £670m cost of the scheme would be found in efficiency savings from Department of Health and local authority budgets. Critics retort that his sums simply do not add up.



QWhat do the Tories propose?

AThey would introduce a voluntary scheme enabling people to pay £8,000 at the age of 65 in return for a guarantee of free residential care if they need it. They are about to unveil plans for a similar scheme to cover the cost of care at home.



QAnd the Liberal Democrats?

AThe credit crunch has affected their plans to offer a minimum level of care for all. They are now calling for the parties to come together to agree a joint solution to the funding crisis.

Nigel Morris, Deputy Political Editor

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