Coping With an Ageing Population: A Caring Challenge that Cannot be Ducked

The Telegraph

August 19, 2009

United Kingdom

In 1997 Tony Blair told his first Labour Party conference as prime minister that he did not want his children to grow up "in a country where the only way pensioners can get long-term care is by selling their home". Yesterday we reported the case of Judith Roe, an Alzheimer's sufferer whose health trust in Worcester ruled, with supreme callousness, that her condition was "social" not medical, and therefore that they had no legal obligation to pay her residential care home costs. Mrs Roe's family – like thousands of others – had no option but to sell her home to pay the bills. Only the intervention of the Health Service Ombudsman righted this injustice and saw that the family had the care costs reimbursed – though Mrs Roe had in the meantime died.

The case exposes the hollowness of Mr Blair's declaration. In the 12 years since he delivered it, the Government has done virtually nothing to address the long-term care problems created by an ageing population, a situation that will worsen in the coming decades. We already have more pensioners than under-16s, while the over-80s are the fastest-growing age group. A Royal Commission report was wisely binned in 2000 after it recommended that all care costs should be met by the taxpayer, but then the issue was dropped until last month, when a Green Paper was published to "start a debate" on elderly care. This reckless unwillingness to confront the big issues facing the country is characteristic of this Government; it extends also to transport policy, nuclear energy and public-sector pensions. Short-termism dictated by the electoral timetable has time and again taken precedence over the national interest.

There are no easy answers to coping with a demographic shift that is hitting all advanced countries, but that is no excuse for running away from the issue. The sooner a new system is settled on, the less painful will be its eventual introduction. The Green Paper offered a number of approaches: the individual and government sharing the costs; an optional insurance-based system; and a compulsory insurance system. While there was a woeful shortage of detail, the last option would appear the most equitable, not least because it addresses the current unfairness in the care system whereby thrift is punished and fecklessness rewarded.

We trust the Government's timidity on long-term care will not be shared by an incoming Conservative administration. Coping with an ageing population will require some extremely tough decisions, which will be best taken early on. As Labour has shown to our cost, if they are not, they never get taken.

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