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Bakewell: who will pay for elderly care?

By Channel 4 News

Updated on 19 February 2010

As Health Secretary Andy Burnham hosts a key meeting on social care reform for the elderly, government-appointed "voice for older people" Dame Joan Bakewell writes for Channel 4 News.

Government appointed

Sometimes unwise and crude political gestures have surprising results. The Tory poster featuring a tombstone and the message "now Gordon wants £20,000 when you die" seems to have had that effect.

Its appeal to the cartoonists as much as anyone has circulated this misleading threat so widely that suddenly far more people have been jolted into awareness than might otherwise have been the case.

So, then, we all know that there's a row about how to pay for the old or indeed how to pay for your own old age when it comes round.

For the first thing to say about this issue is that it is not merely about today's older citizens. It's also about how people now in their 30s, 40s and 50s will fare when their turn comes. 

The increase in general health, and ongoing improvements in medicine mean that more and more old people will be around, wondering how to pay for the basic amenities of life and how to cope with increasing frailty and, in a proportion of; cases, the onset of dementia.

They are unlikely to be able to do that on their own. The wealthiest families today reckon that to pay for the highest standard of domiciliary care now costs around £60,000 a year.

Not many of us are going to be able to afford anything like that. It is also reckoned that residential care these days does not come much cheaper than £26,000 a year. Who is going to pay?

There are only three basic options: the individual, the state, or a mixture of the two.

Emerging options are focusing on the mixture of the two. The issue that has triggered the pre-election spat between the parties is exactly how much and in what form will the state be able and willing to pay.

To what extent will taxpayers be willing to shoulder the burden of those too old to work? And how many of their assets – including their homes – will the old themselves be expected to put into the pot?

If the old want to hold onto their wealth in order to leave something as an inheritance for their children, then the money will have to come from somewhere else. No-one has yet discovered where that might be.

Some weeks ago representatives of the three parties made a selfless attempt to share their thinking on the issue. The attempt was kept secret, which seems a crazy way for adults to behave.

But once the secret was out the party machines went into play to blow the well-meaning initiative out of the water. That is now behind us.

Later today, the Health Secretary Andy Burnham will hold a conference of all the interested parties. The Conservatives refuse to join in.

They have issued a complicated critique of the so-called death tax, assuming it be decided government policy. I understand that is not the case. Meanwhile Tory policy is declared to be "a personalised care system with people protecting themselves from escalating costs though a voluntary insurance scheme." 

In other words, for those who don’t pay into such insurance schemes, the taxpayer pays. This like all the other options needs to be costed, and discussed. It is far too early to set policies in stone.

Dame Joan Bakewell was was appointed a voice for older people by the UK Government in 2008.

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