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Spotlight again on cost of free personal care for elderly

The UK Government's plans for funding social care in England should not be dismissed as entirely irrelevant north of the Border.

Free care for the elderly in Scotland remains one of the most significant achievements of the Holyrood Parliament. Just how bold that measure by the Labour/Liberal Democrat coalition in 2002 was, becomes clear on examining the detail of the scheme put forward by the Health Secretary for England, Jeremy Hunt.

The model proposed in England will cap the amount people will have to pay from their own resources at £75,000. That is a major disappointment because it is more than double the £35,000 recommended by the independent commission appointed to find a way of funding elderly care. The rise from £23,000 to £123,000 in the value of assets people can retain before having to make a means-tested contribution to basic care costs is welcome. But it does not go far enough in ensuring people of modest means no longer have to sell their house to fund their care, despite that being Mr Hunt's stated intention.

The extra cost to the public purse (about £1 billion) is to be found by keeping the threshold above which inheritance tax is payable at £325,000, increasing the number of people liable to pay. In theory the scheme will be sustainable because the cap on costs will encourage insurance companies to offer policies to cover the cost of care. It remains to be seen whether the premiums required will be sufficiently affordable for the majority of people.

These changes do not provide the solution, not least because they will do nothing to improve the quality of care. But they are a step forward in tackling the looming problem of how we provide good care for the most vulnerable elderly people in their last years.

The bill for free personal care for Scotland's elderly population now costs the taxpayer almost £500 million a year compared with £110m 10 years ago. That raises questions about the sustainability of a completely free service.

There remains a commitment in Scotland to social inclusion through funding services from taxation. As increasing longevity results in more elderly people requiring care while the cost of providing it must be borne by a smaller proportion of the population, the fairness of free personal care for all over pension age must be reappraised. The spectre of inter-generational conflict between older people with access to free services and younger generations meeting the bill for these benefits through their taxes while paying off student loans and failing to qualify for mortgages requires a timely assessment of how care can be made affordable for all. If the only way to ensure we can provide free care for those who cannot afford to pay is to levy a charge on those who can, we must begin to consider how that can be achieved fairly.

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