Year: 2004
Type: book
Abstract: Current approaches within the UK to the funding and provision of long-term care for older people have considerable strengths.In comparison with some other countries, levels of services are arguably good and there are increasingly strong mechanisms to safeguard their quality; there is a growing concentration of resources on those with highest levels of need; and cost containment mechanisms are reasonably effective.Nevertheless, the recommendations of the Royal Commission on Long Term Care (1999) and the subsequent actions of the UK Government (in respect of England), the Scottish Executive and the National Assembly for Wales have prompted continuing concerns about the equity, efficiency and sustainability of the current arrangements.Current areas of concern include the following:There are now significant geographical differences within the UK, since personal care is free in Scotland but not in the rest of the UK.The introduction of free personal care in Scotland has, however, not been without some difficulties and its longer-term financial sustainability may be questionable.Particularly outside Scotland, there remain significant differences in access to public funding between older people needing mainly health-related care, free at the point of use; and those needing mainly social long-term care, which is meanstested.Access to public support for those without resources remains heavily dependent on stigmatising means tests, which exclude from public coverage most of those with capital resources.The consequent lack of risk pooling has the potential for inequity and inefficiency in both access to and the utilisation of long-term care, while private insurance covers too few people substantially to fill the gap.Current funding is argued to be too heavily skewed towards acute services and crisis intervention rather than prevention and promoting quality of life (Local Government Association, 2003; Audit Commission, 2004).Public opinion supports a stronger role for state funding than the UK Government appears willing to accept (Deeming and Keen, 2003).These debates are taking place in a context of major demographic change.Between 2001 and 2051, the numbers of people aged 65+ are expected to increase by 61 per cent and those aged 85+ by 169 per cent.Future demand for long-term care arising from the illnesses and disabilities associated with advanced age can therefore be expected to increase substantially, with a corresponding growth of 118 per cent in real-term spending over the next three decades (Comas-Herrera et al., 2003).There Introduction -what is the problem?Funding long-term care for older people
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W1566203516