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NHS chief demands political consensus on funding elderly and social care

Britain urgently needs a new political consensus on paying for elderly and social care, and the funding debate should consider the value of pensions and homes, the boss of the NHS has said.

Simon Stevens said one of the main questions in tackling the huge challenge of how to pay for and look after an ageing population was “intergenerational fairness”.

He wants the government to rescue social care services from their downward spiral of funding cuts and increasing unmet need by reaching an agreement on how such care will be paid for by 2018, the NHS’s 70th birthday. NHS England’s chief executive fears the service will be unable to cope if the recent decline in help received by older people, especially in their own homes, continues increasing demand for medical care.

Without urgent attention being given to the “pressing” issue of social care, there will be a big impact on hospitals, GP surgeries and community health services, he said.

Even more older people will become trapped in hospital despite being fit to leave – a key reason hospitals run out of beds – and more operations will be cancelled unless ministers start seeing social care as a top priority, he said.

Stevens believes David Cameron’s administration should look at all the options for finding the billions of pounds needed, including revisiting the “triple lock”, which guarantees Britain’s pensioners generous annual increases in their state pension until 2020.

In an interview with the Guardian, Stevens suggested ministers should be prepared to risk upsetting Britain’s growing army of senior citizens by looking at whether the benefits they receive are fair to working-age and younger people.

“Would intergenerational fairness support a further increase in the share of public funding on retirees, at the expense of children and working-age people? Does there need to be more flexibility between current disconnected funding streams for older people, so that at times of need everyone is guaranteed high quality social care?” Stevens said.

His comments will raise questions about whether he thinks it is time to stop giving all pensioners a series of benefits – such as free TV licences, prescriptions and bus passes and the winter fuel allowance – regardless of income to boost social care. It includes help for people at home with basic tasks such as washing and eating as well as adjustments to homes to reduce the risk of a frail, elderly person falling, such as grab-rails. Local councils in England have pared back such support in recent years as a result of Whitehall-imposed cuts to their budgets.

Stevens suggested looking again at whether at least part of the money needed to honour the prime minister’s pledge to keep until 2020 the triple lock – which raises the state pension every year by the higher of inflation, the increase in average earnings or 2.5% – would be better spent ensuring effective social care.

“What are the pros and cons of dedicating some of the proceeds of the triple lock to older people’s social care?” he asked.

He also floated the idea that it could become “easier for families to flexibly fund social care by drawing down resources tied up in housing, pension pots, and other benefits and entitlements?”.

Stevens wants the Westminster parties to start talking to each other now, well ahead of the next general election, and find “a settled and durable new political consensus” on social care funding.

“2018 will be the 70th birthday of the NHS. That will be a fitting moment to seek, as the NHS turns 70, a new national consensus on properly resourced and functioning social care services.” The failure to have already put such vital support on a stable footing financially represents “unfinished business”, Stevens added.

Labour, the Local Government Association and older people’s charities such as Age UK criticised George Osborne, the chancellor, for not tackling the issue in his spending review in November except letting local councils levy a 2% precept on council tax rates to fund social care.

The inadequacy of social care means that more and more older people are having their needs neglected at a time when the ageing population means the demand for care has been rising.

“The problem is that too many older people are not getting the support they need to help them stay at home [and] maintain their independence. There clearly is unmet need.”

Osborne’s decision to give the NHS in England an extra £3.8bn in 2016-17, but not give social care more money until later in this parliament, means “there are some immediate pressures” on councils trying to provide decent care.

Last week the House of Commons work and pensions select committee launched an inquiry into income inequality between older and younger people. Research shows that people born between 1956 and 1961 will receive 118% of the amount of money they paid out in taxes and national insurance contributions.

Launching the inquiry the Labour MP Frank Field, the committee’s chair, said: “Is it fair and affordable to divert a large and growing sum of public expenditure toward pensioners – regardless of their circumstances – while mainly poor families with children face year-on-year restrictions on their income? Can the triple lock pension increase pledge be sustainable? Or are these policies needed to guard against pensioner poverty?”

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