Opinion  

Nurses, social care professionals, MPs, older people, carers and disabled charities all seem to agree: the current system is out-of-date, unfair and does not do what it is supposed to.

The government says if things don't change there will be a £6 billion 'funding gap' in 20 years. In the next two decades the number of people over 85 in England will double. Meanwhile, the ratio of people aged over 65 to those aged 20-64 (in other words, those working and paying taxes) is likely to increase from 27 per cent to 48 per cent by 2050.

The system is already under strain. The charity Counsel and Care says three out of four councils only provide care to those whose needs are 'critical' or 'substantial'.

Access to support varies wildly and many elderly people struggle day-to-day, or are forced to move into residential care, because funding for help is unavailable. This is grossly unfair. In addition, the system is vastly complex, making it hard for people to understand what they are entitled to and how to claim it.

Primary care nurses understand this only too well. It is often district nurses or practice nurses that older people and carers come to when they need extra support at home - or help to navigate the system.

The government is waiting for the outcome of the debate before it makes any decision, but is said to favour some form of insurance scheme involving state funding. Clearly it will be impossible for the public purse to pay for everything.

It will take time for any change to filter through and the government must address the current postcode lottery. It is wholly unacceptable if people are forced to leave their homes because their local authority is unable to pay for basic support services while a new system is developed.

Emma Bower, editor, Independent Nurse

emma.bower@haymarket.com