The big political debate last October was inheritance tax, with both parties using this to gain political advantage, yet the provision of long term care and the funding of this long term care can provide a bigger threat than inheritance tax ever did to the wealth of a family and it’s emotional well being.

As with inheritance tax the well educated and prepared can write wills to protect part of the estate from the ravages of care costs, this also in many cases protects the family home from forced sale and relieves an additional worry for someone who is already stressed by needing long term care.

Although funding of long term care costs is likely to be a much more expensive nut to crack than inheritance tax, when can we expect to see politicians take a really interest in solving this issue and abating the vast harm it’s effects have on many families lives?

In meantime, use the devices at your disposal, wills & trusts maybe if enough people protect assets in this way as they did with Nil Rate Band Discretionary Trust Wills, then we might see the rules changed to make a fairer system overall.

It amazes me that, in browsing many web-sites concerned with the subject, I have found not one reference to the Royal Commssion Report of 1999, or its Statement which followed in 2003. Consequently, I have copied and pasted below a message which I originally posted in another thread on this site:-

What I want to know is – why did Gordon Brown as Chancellor, and Tony Blair as Prime Minister, ignore the findings and recommendations of the Royal Commission Report, ‘With Respect to Old Age’, produced in 1999? (The Sutherland Report)?

Following extensive consultation, research and costing, this comprehensive Report looked at various options for funding and finally recommended:

‘The costs of long-term care should be split between living costs, housing costs and personal care. Personal care should be available, after assessment, according to need and paid for from general taxation: the rest should be subject to co-payment according to means.’

The recommendations were implemented in Scotland where care is, in effect, subsidised by tax payers in the south of England.

After the Government’s failure to act, the Royal Commission issued a further Statement in 2003 which included:

‘There are no overwhelming resource implications to the implementation of the Royal Commission’s recommendation. If Government believes that long-term care funding is an important issue – and presumably it does, otherwise the Royal Commission would not have been set up – it can find the necessary resources both now and in the future. More important, the limited changes to the care funding system in England, Wales and Northern Ireland have not addressed the deep-seated issue of inequity, hardship and the need for a principled approach across the United Kingdom. The system in these countries is unstable. If not dealt with in the near future, it will implode.’

Eight years on and we’re still debating it!!!

Both the full Report and the Statement are available on-line. Easiest to ’google’ for them.

Try as I might, I cannot see how to distinguish the needs of those who have a short prgnosis from those who have a long or indeterminate one, and why the former should have free care but the latter cannot. Why should someone suffering from slow-developing Alzheimers Disease not deserve the same standard of free care as someone with a fast -growing cancer?

Those who will die quickly can have free care because it is cheap. Those with long-term conditions are too expensive because they live too long. This is the real reason for the anomaly.

I have 3 proposals:
1. Base all care (personal and nursing) for those who are not going to get better from their illness or old age frailty, on the free palliative care model.

2. Stop trying to distinguish personal and health care. Millions of pounds are being wasted trying to do this and they cannot be satisfactorily separated. Even if they could, what is the ethical case for the state paying for one and not the other?

3. Pay these costs out of taxation. We pay for the NHS this way. It would be an extension of it and seems the most egalitarian way to make the ‘co-payments’ described above. Taxation is itself a system of joint state and individual responsibility.

I know politicans say that this would be politically unacceptable but if the case was made clearly, honestly, persuasively and persistently over a period of months it could be done. Governments are very good at ‘marketing’ ideas and this would be a brave and respected one. I have never met anyone who doesn’t want to be sure they will be looked after well in old age. We are a rich country and can afford the small redistribution of resources to achieve this.