Poorer Families Struggling to Meet Care Bills for Elderly 

The controversial system of paying for long-term care for the elderly is hitting already hard-pressed families, a former health chief admits today.

With many elderly people forced to sell their homes to meet care costs, Sir Christopher Kelly, a former permanent secretary at the Department of Health, says the Government cannot "duck" changes to a system that many saw as iniquitous and complicated.

His comments come as a report by the Joseph Rowntree Foundation, the social research charity, also describes the system of paying for long-term care as "unfair and incoherent".

With the number of over-80s likely to double in the next 30 years, people of all ages needed reassurance that they would get quality care when they needed it, and not have to impoverish themselves in the process, the report said.

It suggested that ministers limit the extent to which people were required to use the proceeds of selling their homes before they were eligible for local authority help with care costs.

It also called on the Government to give a better deal to those on low incomes, who currently have to give up almost all their pensions before getting local authority help for residential care.

Sir Christopher, who chairs the group advising the Joseph Rowntree Foundation on long-term care funding, said: "One way or another, we will have to pay the growing care bill: if we avoid raising more public resources the burden will fall on hard-pressed families. If we delay for too long in confronting the realities of an ageing population it will become much more painful to make the necessary changes."

The Joseph Rowntree Foundation report argues that the present system is unfair because it provides neither a clear-cut set of entitlements according to how much care people need, nor a set of rules about how much they should contribute.

Donald Hirsch, the author of the report and a special adviser to the foundation, said: "In the next 50 years we will have to spend about four times as much in real terms on long-term care as we do now.

"If we keep our present system of public funding, most of the increase will fall on individuals, many of whom will find it difficult to pay."

Options for reform considered in the paper include improving the system that helps pay for residential and nursing care according to an older person's diagnosed condition.

At present, some people get all costs paid by the NHS and others receive very little. A particular anomaly is that some people with dementia who need large amounts of personal assistance with daily tasks may receive little or nothing because they do not require nursing.

The report says limiting the extent to which people have to sell their homes was important. 

Raising the threshold for help in care costs from £20,500 to £100,000 would mean that, at worst, someone selling an average-priced home would not have to spend more than half the proceeds on paying for residential care, it says.