Dr. Ros Altmann is a pensions and economics policy expert and former investment banker, who has advised Governments, corporations, trustees and the pensions industry.

Dilnot review offers real chance to address the care crisis - we must grasp it before it's too late

by Dr. Ros Altmann

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Failing to fund care properly will bankrupt the NHS and leave millions in misery

Pensions crisis was left too long, Care cannot be ignored any more

It is sad to see headlines about next week's official Review into the Funding of our Care system already turning into a political football before it's even published.

This Government has rightly commissioned an independent expert analysis of how to deal with the crisis in our social care system. After recent scandalous headlines of elderly people being denied the care they need, forced to sell everything to pay for care, treated without dignity or left worrying about the security of their care home, surely we must all wake up to the real risks that face our ageing society.

Governments in the past have had major inquiries, but still nothing has changed. We must not fail this time, the crisis is truly upon us. Latest figures today show that spending on social care has been falling - even while the numbers in need of care have been rising. There are huge gaps in our social care budget and even the latest extra £2billion by 2015 that the Government has announced will be given local authorities to fund care has not been ringfenced. So the money is not getting through to where it is needed and local authorities are cutting care spending on the elderly by 8% according to new research from AgeUK.

With the number of older people set to rise markedly, this is another major scandal in the making. There are already huge gaps in our adult social care budgets, with care now being denied to those with moderate needs and focused only on those with substantial or critical needs. This means that nearly a million people who require care are not getting any funding for it. Yet, by funding care now, we can save far more money in future on health spending.

But, so far, Government has been in denial. The private sector has not put any money aside for care at all. Yet care costs tens of thousands of pounds that has to be found if needed. With pensions, at least billions of pounds is already earmarked (even if we know it is not enough to give everyone a comfortable retirement, at least some money is there), but for care there hardly a penny saved by anyone! Where will the money come from? Surely we need a new settlement, which explains to the public why care funding is so important, which allows the private sector to become involved in saving or insuring for care needs and which helps save unnecessary health spending in future.

The Dilnot report will set out a way forward. Government must listen carefully and act.

"Unless Andrew Dilnot's recommendations are taken seriously, acted upon, and not dismissed by politicians as being too hot to handle, then we face a care catastrophe that will make the pensions crisis look like a minor problem by comparison," said Dr Ros Altmann, Director-General of over-50s organisation Saga.

"Care has always been the health sector poor relation in the eyes of the policymakers, but to the people whose relations are in need of care, care funding is essential. If anybody doubts the status of care as the poor relation, you need only to follow the figures.

"In 1901 you could barely fill a football ground with the population of over-85s - there were just 61,000. In 2011 there are 1.5 million and in 20 years there will be 2.5million.

The issue of care is huge, escalating, and relentless. It must not be kicked into the long grass because ministers consider it to be too hot a political potato.

"Failing to fund care will have dire ramifications for the health service, and the economy. Keeping an older person in a hospital bed costs £3000 a week, but caring for somebody outside hospital is under £1000 a week.

We have spent so much on health to keep people alive longer but we now need to ensure we increase resources for care, so the increasing numbers of older people can be properly looked after with dignity and preferably in their own home. If care funding is not addressed then the NHS will be overwhelmed. As the population of older people soars, a new approach is desperately urgent. £83 billion is spent on social security benefits for older people, and £50 billion on the health service - but just £8 billion on social care.

"In recent years the NHS budget has grown but local authority care funding has been cut. It is crucial that more spending is directed towards prevention and intervention - 70% of emergency hospital admissions are down to over-65s who have had falls; such huge costs to the health service could be prevented by the provision of appropriate care and accommodation for older people.


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