Time and money are fast running out for David Gower. Everyday life is a challenge for the 75-year-old pensioner who has lost most of the power in his limbs. He cannot hold a pen or stand unaided for more than a couple of minutes.
Carers visit him four times a day to help him in and out of bed and cook his meals. He relies on a walking frame to manoeuvre around his small flat and can only leave home in a wheelchair.
Mr Gower, who has suffered a severe and worsening neurological disorder for seven years, wants to keep as much of his independence as his condition allows. But the former British Rail manager's determination to stay in his own home is costing him dear. He calculates that his life savings are disappearing at the rate of £400 a month as he struggles to pay his care bills. At that rate all his money will be gone in less than two years.
Mr Gower, who lives in sheltered accommodation in Luton, said: "I have no idea what will happen then. It causes me, and a lot of other people like me, a great deal of concern. It's most unjust. I just want to stay in my own home."
Despite the seriousness of his condition, Mr Gower does not get all his care costs picked up because his needs are categorised as "substantial" rather than "critical". His monthly income, from pensions and benefits, is just over £600. But having to pay more than £300 towards his care on top of rent, food and bills, means he pays £400 from his savings each month.
He is one of many hundreds of thousands of frail and elderly people who receive care in their homes – and many more are in residential care. Many see their savings vanish – or are forced to sell their homes – to provide a modicum of dignity and comfort in their final years.
The system is close to breaking point and can only get worse as the expense of looking after a rapidly ageing population escalates. Forty per cent of the population will be 50 or over by the year 2026 – compared with 34 per cent now – meaning that another 1.7 million adults will require care.
In a report today the Audit Commission reinforces the message with a warning that councils face a daunting challenge in coping with soaring care costs, yet political leaders have so far baulked at facing up to the unpalatable decisions that will be required to tackle the problem.
Last week the Conservatives launched a poster campaign accusing Gordon Brown of plotting a £20,000 "death tax" on the estates of the newly deceased, and tomorrow the Tories will boycott an emergency conference called by Andy Burnham, the Health Secretary, to debate ways of tackling the funding crisis.
The issue looks certain to feature heavily in the general election expected in May – and will be given extra potency by the high turnout among older voters. The health spokesmen for the three main parties held secret talks either side of the New Year in an attempt to agree common ground on the issue. They collapsed in acrimony, with Labour and the Tories blaming each other for sabotaging the negotiations.
The fall-out continues. Mr Burnham has accused Andrew Lansley, the shadow Health Secretary, of spreading scare stories about Labour's intentions. Mr Lansley, who says the Government has wasted 13 years in which care could have been reformed, insists he will not go to the conference until Labour has ruled out imposing a levy on estates. Norman Lamb, the Liberal Democrat health spokesman, wrote yesterday to urge Mr Lansley to attend. He said: "We must set party loyalties aside and try to get to grips with this problem."
Michelle Mitchell, charity director of Age Concern and Help the Aged, reflected growing alarm among charities over the mug-slinging between the parties. She said: "The issue of social care is rightly in the spotlight; however it must not become a political football between the parties.
"Millions of older people and their families have been let down for far too long by an inadequate care system. The system is already underfunded and quality of care is often poor. Older people and their families deserve a care system which enshrines dignity and fairness – unless we act now it will crumble even further as our society ages."
As his savings ebb away, Mr Gower can barely contain his anger at the political point-scoring that has wrecked attempts to overhaul a system universally regarded as unfair. He is so disillusioned over the Government's failure to act that for the first time in 50 years, he will not vote Labour at the election. But the Tories and Liberal Democrats can take no comfort – he will support an independent candidate.
"All three main political parties have known for the last 20 years that this demographic problem is coming up. They have chosen to totally ignore all the warnings that care is in crisis. They don't want to accept responsibility – they have all adopted an out-of-sight, out-of-mind attitude."
How does the current care system operate, and how can it be improved?
Q. What is the system at the moment?
A. Anyone 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.
Q. And why does this system not work?
A. There 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.
Q. How has the Government responded?
A. Slowly 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.
Q. What has Labour said on the subject since then?
A. Gordon 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.
Q. What do the Tories propose?
A. They 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.
Q. And the Liberal Democrats?
A. The 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 EditorReuse content