Mark Ellerby: We need a system of social care that is simple and free

The Government recently named the members of its Commission on the Funding of Care and Support in England. At a time when public funds are scarce, these individuals will be working together over the next year to try to find a solution to the question: how can we make care accessible to the least well-off without penalising those who have saved all their lives?

There is no easy answer. Two previous commissions, a green paper and extensive consultations have not yet managed to resolve the issue, but the status quo is no longer an option either. The system in England urgently needs more money to meet the needs of older people. Industry figures show some hard-pressed councils are paying fees that equate to less than 2.50 per hour to care for frail and vulnerable old people in

nursing homes. This is simply not enough.

Caring for nearly 30,000 people in residential homes in the UK, Spain, Australia and New Zealand, we work within many different systems of social care. Our experience is that some form of partnership between state and individual is needed to build a sustainable system.

We believe that everyone should be entitled to a standard level of "free" care. In return, all who can afford to pay a contribution should do so through either an insurance scheme, or from their savings. However, other countries' experiences suggest that voluntary systems won't provide enough new money to finance the extra demands of our ageing society. So any form of insurance system would have to be compulsory if it were to succeed.

But it's not only a question of finance; the Government needs simultaneously to put the building blocks in place to create a simpler and fairer system.

Every week, we come face-to-face with families struggling with the emotional stress of finding care for a frail relative. They then face the added burden of navigating their way through the labyrinth of rules surrounding state funding.

A key frustration is the postcode lottery that leaves people unsure about what to expect locally, how to find accurate information on care provision, and bouncing between the NHS and local council. The decisions of these hard-pressed local councils or primary care trusts often reflect their straightened budgets rather than the individual's needs. As a result the "benchmark" to qualify for "free care" varies significantly and people's needs go unmet.

We have not seen a perfect system in action, but some countries have already implemented plans to combat the demographic trends and financial constraints that we face. Australia, for example, has a national, standard system of assessing care needs which is a better way of allocating limited funds and simpler to understand. While a national telephone service and website for example, would help to provide one single access point to information. This has worked well for other public services.

An ageing population living with diseases such as dementia also means more people will need support in the future and expect the option of residential care to be available. But the round-the-clock, quality

nursing care that can be accessed today won't be able to be delivered on the scale needed in the future without investing in the system now. Again, taking the opportunity to learn from Australia and other countries might be useful where the Government uses national capacity planning to better anticipate future demand for care and ensure

that services are provided to meet them.

People also tell us they want choice. That means individuals controlling their own budget so they can source the care they want. That is why any new funding system should not incentivise one particular type of care over others – whether that is supporting people in their own homes, in assisted living accommodation, or in residential care with specialist nursing. All have a role to play.

As the Commission ponders how it will create a sustainable funding system for the future, it will be important for Government to bear in mind this: if people soon have to pay for care that they always

thought would be "free", then a system that is simple, fair and offers them choice is the least they deserve.

Mark Ellerby is managing director of Bupa Care Services in Leeds