Join the Big Care Debate

A radical reform of care and support services.

Everyone in England will have access to a National Care Service that is fair, simple and affordable under plans set out by Health Secretary Andy Burnham in the Green Paper Shaping the Future of Care Together.

Huge pressures are being put on existing services. More people need care because they are living longer - in 1948 life expectancy was 66 while today it is 78. For the first time there are more people over the age of 65 than there are under the age of 18.

The current system is also unfair. Some people have to pay tens of thousands of pounds or sell their house, to pay for care. Someone with Alzheimer's, for example, could have to pay up to £200,000.

The National Care Service will create a level playing field and end the postcode lottery of care services. Everyone in England will be guaranteed:

  • prevention services - the right support to stay independent and well for as long as possible and to delay care needs getting worse
  • national assessment - care needs will be assessed and paid for in the same way across the country
  • joined-up services - all the services will work together smoothly
  • information and advice - the care system will be easy to understand and navigate
  • personalised care and support - services will be based on personal circumstances and need
  • fair funding - money will be spent wisely and everyone will get some help meeting the high cost of care needs.

The Big Care Debate will canvas the public's and people who work in care and support services' views on what the National Care Service should look like and how care should be paid for. Currently care is not free. More than 50 per cent of over 65 year olds will need care costing at least £25,000. Today's 65 year olds will need care costing on average £30,000. But many people end up paying much more.

Twenty per cent of people will need care costing less than £1,000 - but 20 per cent will need care costing more than £50,000. And people have no way of knowing which category they will fall into.

Under the National Care Service, everyone will get some care for free. The Government wants to hear people's views on how we balance what it is fair for everyone to pay, against the need to project some people having to pay huge care costs.

There are three proposals for funding a National Care Service:

  • partnership - the responsibility for paying for care would be shared between the Government and the person who has care needs. The Government provides between a quarter and a third of the cost of care, more for people on a low income. Today's 65 year olds will need care costing on average £30,000
  • insurance - the same as partnership but the Government could help people to prepare to meet the costs that they would have to pay for themselves, through an insurance-based approach. As well as receiving between a third and a quarter of the cost of care, the Government would make it easier for people to take out insurance to cover care costs. It is estimated that the cost of insurance could be around £20,000 to £25,000
  • comprehensive - everyone who can afford it would pay into a state insurance scheme meaning everyone who needs care will receive it free. It is estimated that the cost of being in the system could be between £17,000 and £20,000.