FEAR OF FINANCE

Not so long ago it would have been impossible for a charitable organisation like Help the Aged to support, still less to advocate anything as radical as a compulsory state or private insurance scheme to fund the long-term care of the elderly and infirm who will make up an increasing proportion of the UK population over the next 30 years. Its proposals would have been exemplary but it would have concluded with a call for the Government to find the money.

The fact that Help the Aged has now accepted that long-term care might need to be funded privately, from compulsory contributions, is a measure of the way in which most people accept that the problem is too big for a government which has already spent much of the proceeds of privatisation programmes and North Sea Oil to fund out of future taxation.

It should also persuade the Government that Help the Aged's detailed contributions to the national debate on long-term health care, which will begin when the Government's consultation document is published shortly, should be seriously considered and not treated as the idealistic or ideological blatherings of some soft left pressure group.

Its starting point is that the present situation of paying for long-term care in either residential or nursing homes is neither appropriate nor fair. This is accepted almost universally, by the middle classes who have seen their assets and inheritances run down and sold to pay for care which the poor get for free, and now by the Government.

But the actual costs of long-term health care for those unfortunate enough to need it are beyond the means of most families, and the full cost of insuring for indefinite care is almost as prohibitive. The Government's preferred plan for the state to take over the cost of care for individuals who take out a limited amount of private insurance once they have exhausted the proceeds of their policies and run down their assets to say pounds 60,000, is only a palliative.

It will bring little new money into health care, it will still deplete the assets of those unfortunate enough to need care for long periods, and it does little or nothing to help the majority of elderly people, those who die before they are infirm enough to qualify for residential care and those who need care but in their own homes.

A fair and comprehensive solution requires that policies which do not pay out because the policyholders die before they can claim should pay something back to the families of the policy-holders.

It also requires that individuals who need care in their own homes should be able to claim for the care currently given them by unpaid relatives and friends.

Age Concern believes that care which is free at the point of need is essential, but paid for in advance by compulsory contribution and providing care at home as well as in residential homes. It also proposes a national standard to assess the qualifications for care.

It has a great deal in common with proposals for financing future pensions out of compulsory contributions to a central fund. But neither concept will solve the transitional problem of providing funding for those now too old to provide fully or the ongoing problem of funding those who will never be able to afford it for themselves.