The partnership government has set out its programme for social care and disability over the next five years

“The Government believes that people needing care deserve to be treated with dignity and respect. We understand the urgency of reforming the system of social care to provide much more control to individuals and their carers, and to ease the cost burden that they and their families face.

• We will establish a commission on long-term care, to report within a year. The commission will consider a range of ideas, including both a voluntary insurance scheme to protect the assets of those who go into residential care, and a partnership scheme as proposed by Derek Wanless.

• We will break down barriers between health and social care funding to incentivise preventative action.

• We will extend the greater roll-out of personal budgets to give people and their carers more control and purchasing power.

• We will use direct payments to carers and better community-based provision to improve access to respite care.

• We will reform Access to Work, so disabled people can apply for jobs with funding already secured for any adaptations and equipment they will need.”

Source: DH website

The debate about the funding of long term care has rumbled on for the past decade driven by:- increasing numbers of older disabled people; rising expectations of services; tightening eligibility criteria; the impact of means testing and a widespread sense of unfairness about the “postcode lottery” for services.

In 1999 the Royal Commission on Long Term Care for the Elderly recommended that the state should pay for all long term personal care. This idea was rejected by the UK government though a policy of free personal care (but not hotel costs in residential care) was introduced by the devolved administration in Scotland in 2002.

In 2006, Sir Derek Wanless’s Kings Fund-commissioned report set out six funding options for funding care. Sir Wanless expressed a preference for a “partnership model” which would give a basic, minimum level of care to everybody, put an end to means testing, and allow people to finance more sophisticated care packages by matching funding up to an agreed amount from government.

In October 2007 the government committed to long term reform and promised a green paper on the future of care and support. The paper “Shaping the Future of Care Together” was delivered on 14th July 2009 and proposed to establish a national care service, providing all people with care needs above a single England-wide threshold with access to some public sector funding for their care. This would be a minimum of a quarter to a third rising to a full support for those on the lowest income.

It put forward three options for funding this.

• A partnership model under which individuals are left to meet their care liabilities themselves

• An insurance model under which people would be invited to enrol in a state-backed insurance scheme – either run by the state or private insurers

• A compulsory state insurance scheme

The Labour government planed to follow their green paper by a white paper in 2010 however this plan was interrupted by the election.