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Care for elderly a priority

Care for elderly and cutting costs are priority, says Andy Burnham…17th October 2009

The Times, by Sam Lister

The NHS must be “re-engineered” to cope with the demands of an ageing population, the Health Secretary has told The Times.

Politicians would have to grow up over the issue of cutting hospital-based services and moving more care into the community.

Andy Burnham said that care for the elderly, and tackling the unfair costs that force many families to sell their homes and use up their savings, should be the priority issue on which people vote at the general election next year. Taking care out of hospitals and closer to people’s homes would be central to this vision.

In an attack on Conservative policy, Mr Burnham said that the public should not be deceived by the “dishonest, hopelessly optimistic and fundamentally wrong” claims about how to address problems with old-age care.

A four-month public consultation on the future of care services, which finishes on November 13, had revealed strong support for a comprehensive funding model where everyone who could afford it would pay into a state insurance scheme and then receive complete cover.

He said that the Tories’ promise, announced this month, of free residential care for anyone who pays a one-off fee of £8,000 was “180 degrees wrong” on both cost and as a vision that encouraged the use of care homes rather than helping people to live in their own homes.

“The system as it stands is unfair and if we don’t tackle it, the unfairness will grow year on year as the population ages,” he said. “This has to be a fundamental election issue. I make no apologies for that, but you cannot conduct this debate on a dishonest basis. You have to be absolutely straight with people about the costs of care in the future and how they can be met.

“Not only are the Tories’ figures wrong, their vision for the future is fundamentally 180 degrees the wrong one. They have a very backward-looking vision and a threadbare policy. They are creating an incentive for putting people into residential care.

“For me the future is about helping people stay in their own homes. It is about wrapping support from the health service and local government around people.”

Speaking to The Times at a roadshow for the Big Care Debate in East London, Mr Burnham said that the next few years required more NHS reform than ever. He said that politicians had to show maturity over how the system was reconfigured and the possibility of cutting back hospital services. “The NHS is going to have to be re-engineered towards more care in the home, and Parliament is going to have to grow up [about this] and see the bigger picture.”

Mr Burnham added that the debate would be derailed if the House of Commons became “600 Richard Taylors” — a reference to the independent MP for Wyre Forest, a former doctor, who stood for election on the sole policy of preventing his local hospital closing.

“The NHS will face more reform than at any time in its past to cope with the demands of an ageing population,” Mr Burnham said. “Reform was initially about getting people through the door, and we have dealt with those big challenges. Now it is about quality — how we drive up quality and standards and get people-centred care in the NHS.”

In July the Government set out a choice of three models to fund a new National Care Service in its Green Paper, Shaping the Future of Care. It offered a partnership model, a voluntary insurance scheme and compulsory insurance providing free care for all who need it.

The Government has already ruled out full state funding from general taxation, because it would place too great a burden on people of working age, and retaining the “pay for yourself” system, which is unfair to those who need years of care. The consultation will run until next month, with the chosen system expected to be published in a White Paper next year and phased in from 2014.

The average cost of care for people after the age of 65 is £30,000. Under the means-tested system those with a home or savings of more than £23,500 have to pay for their own care. Mr Burnham said that the comprehensive option appeared to be the most popular with the public so far, which he put down to the “peace-of-mind factor”.

“If you are in, then it is on NHS principles and people are comfortable with that idea,” he said. “Once you are in you are covered, and I think that’s the peace of mind in retirement that people are looking for.”

But the Health Secretary added that this would not necessarily mean that the comprehensive option would be adopted, with the views of stakeholders, including charities and care providers, yet to be collected. Consultation is scheduled for early next month.

“It is a complex debate, because there are issues with the comprehensive option,” he said. “It’s a very difficult thing to say to people that you must pay. It may come out better because people think of care in the same way they think of the NHS, but it’s a different matter when you have to say that everyone has to pay a certain amount.”

The National Care Service would offer assistance with needs such as dressing, washing and moving around at home, but those who had to go into residential care would continue to pay the cost of accommodation and food, whether they had insurance or not. New arrangements would allow for bed and board costs to be deferred and paid as a lump sum after death.

The Department of Health is also consulting on whether insurance costs should be deferred until after death, paid in instalments or given in a lump sum when someone reaches retirement age. Under all three options, those with little or no savings or assets would receive free care.

(http://www.timesonline.co.uk/tol/life_and_style/health/article6878249.ece)

 
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