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Varying Shades of grey

During the run up to the general election, the campaign teams of all the main parties have been canvassing elderly voters in an attempt to win the all-important grey vote. One of the main reasons for this is that turnout at this election is expected to be dismally low and it would appear that the over-55s have a greater propensity to turn up at the polling station whatever the weather.

Issues such as pensions and long-term care are therefore seen as key to success in the election. With this in mind, I would like to look at how Labour&#39s policy on long-term care for the elderly has evolved since the last election and to explore whether there has been any change in direction in the recent election debate.

At the time of the 1997 general election, the Conservative Government had been pushing a Bill through Parliament proposing a partnership scheme between the state and the individual to help fund long-term care. Labour announced it would be taking a step back to adopt a more holistic view of the issues and, if elected, would appoint a royal commission to work out a fair system of who should pay for what.

At that time, Labour also proposed the introduction of a long-term care charter to define the standard of services which people should be entitled to expect from health, housing and social services. It also promised an independent inspection and regulation service for residential homes and domiciliary care.

After Labour had won the election, it introduced a set of standards for nursing homes to benefit those people currently receiving care. However, the focus of most people&#39s attention was on how long-term care should be funded in the future. Fifteen months after it was appointed, the royal commission, under the leadership of Sir Stewart Sutherland, made various recommendations to the Government, which responded to the recommendations as part of its comprehensive spending review under an NHS Plan which made wide-ranging proposals on investment in the health service.

These included substantial investment in healthcare for the elderly and covered the introduction of free nursing care in nursing homes up to a value of £5,000 a year.

It was made clear that the elderly would continue to pick up a substantial proportion of the costs of their own care if their assets exceeded the means-test threshold (currently £18,500).

The NHS Plan was heralded as a long-term solution to improve the quality of health provision and it is still a key part of Labour&#39s manifesto proposals. The plan pledges a £1.4bn investment in health and social services for older people. There are also plans over the next three years to spend £500m on providing financial support for carers, with a further £255m to be allocated to social services towards care provision.

In the last six months, there has been considerable publicity surrounding the Scottish Parliament&#39s plans to explore ways in which it can go a step further for the elderly in Scotland. It wants to implement the main recommendation of the royal commission to provide free personal and free nursing care. Despite some pressure at the time, Tony Blair made it quite clear that the rest of the UK had invested heavily in healthcare for the elderly, that the Government had explored that particular option and felt that its proposals represented the most sensible and fair way of spending its increased budget for elderly healthcare.

In their election manifesto, the Liberal Democrats have pledged free personal and nursing care for everyone in the UK. The Conservatives have said they will consider how people who have made prudent provision in advance for the cost of long-term care can be protected from having their assets taken by the state, if their care costs are more than could reasonably be foreseen.

It is not my role to persuade you one way or the other of the validity of the political arguments. Naturally, Labour is sticking to its guns and part of its defence is based on its own attack on the financial credibility of its opponents. According to the Labour website, a Conservative spokesman, Oliver Letwin, reportedly told the Financial Times that his party could cut £20bn off public spending to help to fund tax cuts. Labour maintains that a wide range of priority areas would be hit by cuts of this magnitude, including 40 per cent of the expenditure allocated to pensioners.

The Conservatives and the LibDems have argued against Labour&#39s ability to deliver its proposals on public services. The NHS Plan promises that by 2004 there will be 20,000 more nurses, 7,500 more consultants, 2,000 more GPs and 6,500 extra therapists. These are huge recruitment targets and, putting any financing questions on one side, it is the “how” which is being questioned.

Where does this leave us on funding long-term care? There has been no indication that Labour will change its mind on plans that were already in place before the election was called. Before Parliament was dissolved, the Heath and Social Care Bill was pushed through the final approval stage. This will introduce free nursing care for the elderly in nursing homes from October except in Scotland. The Scottish Parliament&#39s free nursing and personal care proposals will not be known until August.

Opinion polls have indicated it is likely that Labour will return to power, so what can we expect this time round? The party has laid out its strategy for health, which includes a greater emphasis on a public-private partnership. It says this will help it to deliver its manifesto promises and provide people with the healthcare they need at the time they need it.

Both the main parties have stated they recognise the role that long-term care insurance has to play in providing protection for the elderly. Labour is proposing the introduction of Cat standards and full regulation of insurance to help protect the consumers it expects to buy these products.

I am convinced there is a lot of work to be done, in partnership with the Government, to help a growing elderly population not just to have the long-term care they want but also to give them the power to choose how they can best protect their way of life.


Edward Vaizey

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