Tom Utley, commmenting on Sir Derek Wanless’ report in the Telegraph today, bravely puts forward a point of view on care for the elderly which is not often publicly expressed:
One of Sir Derek’s ideas is that most means-testing should be abolished, so that many fewer pensioners will be forced to sell their homes in order to pay for their care. I understand the appeal of what he says, because means-testing punishes the thrifty and rewards the profligate.
But I am now going to make myself extremely unpopular by saying that I don’t really see why pensioners shouldn’t be expected to sell their homes in order to pay for their care in old age.
Many will argue that they have financed the NHS and the social services by paying their taxes throughout their working lives – and so why shouldn’t they reap in their old age what they sowed during their youth?
The trouble is, of course, that most of today’s pensioners did not sow nearly enough during their working lives to cover the costs of looking after them in their dotage. If only the NHS were a proper insurance-based service, as it was originally intended to be, then they would have a point. But it isn’t – which is why we are in this mess.
There is, as we all know, a very much better way of looking after the elderly than simply shovelling money in the direction of strangers, in the hope that they will look after them.
I am thinking of the most effective social security system ever devised by man or nature. It is a system that still operates in most primitive societies, but one which is on the verge of collapse in modern Britain.
I mean, of course, the family.
In almost every way, I would much rather live here than in a mud-hut village in Africa.
But I reckon that the very old in the Third World, looked after by their families in communities bustling with life, have a much better time of it than a great many British OAPs, sitting around in care homes stinking of urine, watching afternoon television and counting the days or weeks until that rare visit from their young.
There is more on this in The Welfare State We’re In in the chapter on pensions. The section starts on page 299 with Octavia Hill’s comments on pensions to a Royal Commission the late 19th century.
There are several ways of dealing with that minority of the elderly who need prolonged special care in old age:
- care at home or in an institution, paid for out of savings, insurance, mortgaging the home (and getting an annuity) or (if going into a care home) selling the home.
- care by the family or paid for by the family.
- care at home or an institution paid for by other taxpayers.
The apparent attraction of the last one is undermined by several factors:
- people come to rely on it but then find that, like most services theoretically provided by the state, it is rationed and not always available to those that need it. (This results in elderly incapable people living dreadful, lonely lives at home. They sometimes effectively starve themselves. It is quite possible for them to break a bone and then be unable to get help, causing them to die in dreadful circumstances.)
- children come to think that their parents are the state’s problem, not their own. Their way of thinking about the issue – and thus their behaviour – changes.
- people come to think it is not worth saving and amassing capital because it could all go on the cost of a care home and, if they have no capital, the state will pay for the care anyway. So why bother saving?
- some people are likely to cheat or else legally take measures to avoid paying for their own care. They will hide their assets or give them away so that their children get their money while the state pays for their care. Or, to be more accurate, other people will pay for the care of their parents.
- The elderly British appear to be among the most neglected in the world
- ‘We have more compassion for animals in this country than our elderly’
- Why poor parents in Miami send their children to a private school
- Parents live apart ‘to cash in on benefits system’
- Italy used not to pay lone parents much. Lo and behold, there were very few lone parents.