Government accepts care costs cap

The Government is ready to accept the key recommendation of a report on support for elderly people and place a cap on the total amount individuals are expected to pay for personal care in their old age, Health Secretary Andrew Lansley indicated today.

But Mr Lansley made clear that no decision has been made on the level of the cap beyond which the state will pick up the bill for care.

The Health Secretary today said he expected to give a "very positive" response to the report of the Dilnot Commission on the Future Funding of Care and Support when it is presented tomorrow.

Economist Andrew Dilnot's central recommendation is expected to be an overall cap of between £30,000 and £50,000 on the total amount any individual has to pay for care - at an estimated cost to the Exchequer of £2 billion or more a year.

He believes this would save thousands of pensioners from having to sell their homes to pay for residential care, and would enable insurers to offer cover for the potential cost of personal care.

Experts suggest companies could offer insurance to cover care costs of up to £50,000 for a one-off premium of around £17,000.

Dilnot's Commission is also expected to recommend a more generous threshold for means-tested assistance from the state, which currently goes only to those with assets worth less than £23,250.

Charities today issued a call for all-party talks to ensure that reform is not kicked into the long grass, and Prime Minister David Cameron and Labour leader Ed Miliband have both said they are ready to take part in discussions of this kind.

Mr Lansley said that he would also like to see charities and representatives of elderly people and their carers contribute to the debate on the Dilnot's recommendations.

The Health Secretary - who said he had not yet read the report - told BBC1's Andrew Marr Show: "I think we are going to give a very positive response. We are going to treat it as the basis for engagement."

But he added: "Andrew Dilnot's Commission makes clear that there is a range of issues within their own report that need to be resolved and on which it is fair for people to be able to express their view: Where a cap should be set; how it is to be paid for; issues with the threshold for the means-test; how the means test should be applied to people in the future, so they contribute to the cost of their care.

"And of course if people are in residential homes, they raise the question of the extent to which they should pay for their accommodation costs - as it were, their 'hotel' costs in residential homes.

"There are a range of questions within Andrew Dilnot's report and questions beyond it of how we delivery quality care, how we give people proper protection and how these issues are to be paid for."

Mr Lansley made clear that keeping the status quo is not an option.

"We will not be able to give people the quality of care and support and the sense of security that they need in the future unless we have change," he said.

Tomorrow's report is also thought likely to propose a single set of rules to determine what help elderly people need, to end a "postcode lottery" which sees councils operating their own criteria, resulting in people with similar conditions receiving greatly varying support depending on where they live.

The current system of support for the elderly is widely regarded as a lottery, as one-quarter of 65-year-olds can expect never to need care, while another quarter will face bills of more than £50,000 and one in 10 - often those who spend long periods in residential homes suffering from dementia - will have extensive needs costing more than £100,000. Some 20,000 people a year are thought to sell their homes to pay for care.

Mr Dilnot has described his report as a "once-in-a-lifetime chance" to fix a broken system which cannot cope with an ever-growing number of old people. There are now 1.5 million over-85s in the UK, and the figure is expected to climb steeply as a result of increased longevity.

Mr Miliband yesterday wrote to Mr Cameron and his deputy Nick Clegg offering to put aside Labour's proposals for a levy on the estates of the deceased to pay for care - derided as a "death tax" by Tories - in order to seek cross-party consensus.

In an interview with The Sunday Telegraph, Mr Miliband said he had written to the Conservative and Liberal Democrat leaders to offer talks "in good faith", with no preconditions.

The Labour leader wrote: "In return, I hope you both will show the same kind of leadership of your parties as well. The last thing Britain needs is for Andrew Dilnot's proposals to be put into the long grass.

"We three party leaders are of similar age and the same generation. This is a once-in-a-generation opportunity which our generation must address."

A Downing Street spokesman said Mr Cameron had already made clear he "thoroughly welcomes" offers of all-party talks when Mr Miliband first proposed them last month.

Number 10 said: "Social care is a very difficult issue to get right for the country - the long-term costs, how we share them and how we pay for them.

"We would of course welcome the opportunity for cross-party work in this area, to make sure we get the best possible system for the future."

Meanwhile, a group of 26 charities, including Carers UK, the Alzheimer's Society and Macmillan Cancer Support, wrote to the Sunday Telegraph urging politicians to enter into cross-party talks and set a timetable for reform.

"We cannot stick our heads in the sand and ignore the stark demographic reality of a rapidly ageing population and people with disabilities and long-term conditions living longer," said the letter.

"Our political leaders must take this opportunity, and must not let reform fall off the table for another generation. Otherwise the terrible stories of the last months, of neglect and abuse of the most vulnerable, will only grow worse."

There was speculation today that Dilnot may recommend that state support be calculated on the basis of rates for care set by local authorities, rather than the actual bills paid by families.

This raises the prospect that those opting for more expensive residential care homes - which can cost up to £800 or £900 a week, compared to typical local authority bills of around £500 - may spend significantly more than the cap level before receiving state support.

Mr Lansley made clear that the Government accepted the principle that people should be enabled to prepare for the potential cost of care in their old age by taking out insurance, rather than taking the risk of losing their homes and all their savings.

"What we want to do, and what Andrew Dilnot makes clear he wants to do, is make it possible for people to prepare for their contribution to costs in old age and for a partnership between the state and families and individuals," he told interviewer Andrew Marr.

That preparation for old age should mean that "people don't have a catastrophic loss of everything they have worked for in their lives", he said.

Calling for a wide discussion on Dilnot's recommendation, Mr Lansley said: "We have got to work beyond political parties. There are the representatives of all those older people and their carers' organisations who have a legitimate part to play in this."

Mr Lansley later said that the solution to care and support for elderly people should not impose additional burdens on the taxpayer.

The Health Secretary told Sky News's Murnaghan: "It wouldn't be fair, in (Dilnot's) view, for there to be another shift, with people of working age paying additional taxes in order to support those who are older receiving additional benefits.

"The burdens falling on the working age population are already great."

He added: "If we are going to have a system which is enduring and successful and looking after people in their older years, then we have to have something which is clearly going to give confidence in the longer term, which isn't going to be subject to arbitrary changes.

"In that sense it is like pensions. For pensions, people are going to have to make provision during their working life. For care and support, I think probably (it will be) at the point at which people reach retirement age."