No end in sight to elderly care problems

28 Oct 04
Problems with care services for elderly people will continue until policy conflicts over funding levels and models of service provision have been resolved, a leading health care think tank has warned.

29 October 2004

Problems with care services for elderly people will continue until policy conflicts over funding levels and models of service provision have been resolved, a leading health care think tank has warned.

In an interim report published on October 28, the King's Fund drew out a range of concerns shared by almost 200 stakeholders across London. These included funding pressures, staff shortages, lack of choice and a scarcity of places where they are needed most.

The report's author, Janice Robinson, said the problems were well established. 'What is new for us is that we can't see the prospect of any substantial improvements until some of the policy dilemmas have been resolved,' she told Public Finance.

Robinson said there was no consensus over what the ideal balance of service provision should be: how much should be provided by residential care homes as opposed to home-based care or sheltered accommodation schemes.

Similarly, she said, a 'huge debate' was needed to determine future funding levels and what proportion should come from the public purse and what from personal assets.

There is also concern that too many resources are concentrated on the small number of older people with high care needs. This means that those with moderate needs miss out, as does health prevention work.

'The government has to take a lead in shaping policy and is consulting on what that should look like,' Robinson said. 'Our impression is that there's an open door.'

The government has promised to bring out a green paper on social care by the end of this year. Robinson said that although it was due to set out a comprehensive vision for the future, it was unlikely to address the question of who should pay.

Final recommendations are expected from the King's Fund early next summer.

A separate report from the Institute for Public Policy Research called on ministers to instigate a 'Wanless-style' review of social care. It suggested that local authorities be required to develop a workforce strategy for the recruitment and retention of social care staff.

IPPR senior research fellow Deborah Roche said: 'With spending on social care as a proportion of national income due to fall, now is the time for the government to conduct a long-term review. Any future cuts may impact on the attempt to transform the NHS from a sickness service into a health service.'

PFoct2004

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