TERRY DIGNAN:                At an exercise class run 
by Age Concern in York, elderly citizens work out, slowing the process 
of physical decline. They've paid their dues and expect to be treated fairly 
if they do succumb to frailty or disability. To add to their disappointment 
over small pension increases, there's resentment too that under Labour, 
they're still being forced to run down their savings and sell their homes 
when they do need long term care.

MURIEL:                    If you work hard all your 
married lives, you're thrifty and you've managed to save a little nest 
egg, you're penalised and you have to pay.

VERA:                    You have worked and saved 
for it and it should go to your children.

DIGNAN:                    The Government's long-awaited 
decision on how to fund long term care is certain to affect its ability 
to regain the confidence of older voters. They expect Labour to keep its 
promise to end the injustice caused by the way care is currently paid for. 
 Labour came to power in Nineteen-Ninety-Seven promising to address the 
biggest grievance of many older voters.

BLAIR:                    I don't want a country where 
the only way pensioners can get long term care is by selling their home."
  
BURSTOW:                    Since he's come to power 
over a hundred thousand people have had to sell their homes, and I think 
many people quite rightly feel betrayed. The promise before the election 
was very clear. The promise has not been acted upon and it looks now as 
though we won't get any delivery from this Government on long term care 
this side of a general election.

DIGNAN:                    If nursing care in a hospital 
is, rightly, say older voters, provided free of charge by the National 
Health Service, then why should they have to pay for it in a nursing home? 
Those needing nursing care are means tested to decide  what they should 
pay towards the bill. Assets - such as an individual's home - and savings 
are assessed. Anyone with more than sixteen thousand pounds' worth must 
meet the full cost.
  
SQUIRE:                    I think it's a fundamental 
injustice that someone who has a chronic illness like dementia, Alzheimer's 
disease, is expected to pay for their nursing care, because inevitably 
the disease means that eventually they will need nursing home care, whereas 
someone who is termed as having an acute illness like cancer, which may 
nevertheless require several years of nursing and medical support and care 
is entitled to entirely free NHS provision.  

DIGNAN:                    Charlie Squires has Alzheimer's. 
The NHS won't pay his Devon nursing home's three hundred and fifty pound 
a week bill. And nor will social services because Mr Squires owns a house 
worth more than sixteen thousand pounds. His son intends persuading the 
courts it's morally wrong that the health authority won't fund his father's 
care.
    
SQUIRES:                    My father has worked all 
his life, paid his dues, never complained, as far as I can recall never 
had a day off work, he's never been unemployed and now at the, in his last 
remaining years he's being stripped of his assets and told that he's got 
to pay for something that everybody else receives completely free of charge.

DIGNAN:                    Labour set up a Royal Commission 
to find a solution to the problem.  It said residents of nursing homes 
should continue to pay towards their accommodation and living costs. But 
the means test would be less stringent. The threshold for taking assets 
and savings into account would rise from the current sixteen thousand pounds 
to sixty thousand pounds.  But the Commission agreed no one should have 
to pay for their nursing care. It would be free, as it is in hospital. 
The Commission then went further, arguing that the costs of personal care 
should also be met - this meant care involving touching such as combing 
hair and helping with dressing and bathing.  The Commission estimated it 
would cost in total up to one point two billion pounds in extra public 
spending to provide free care.
      
HINCHCLIFFE:                Nobody objects to paying the 
board and lodging costs, the accommodation costs which would - the food 
costs which would normally be - would apply any set of circumstances but 
the personal care should be supplied free as it used to be within the original 
concept of the welfare state and the NHS.

DIGNAN:                    But two members of the 
Royal Commission disagreed. Their minority report said making all care 
free would be too expensive.  Whilst accepting nursing care should be free, 
they said personal or social care should continue to be means tested.  
And whereas the Commission's majority said the threshold for paying the 
full bill should be raised from sixteen thousand to sixty thousand pounds, 
the minority proposed thirty-thousand.   The majority's proposals would 
require an extra one point two billion pounds from the Government. The 
minority's recommendations, at a hundred and ten million pounds, would 
 only be a fraction of that cost.    The minority report said if all care 
was made free, only the better off who currently pay for private nursing 
care would benefit. The poorest have to rely on what social services can 
afford. And that's not much.

LIPSEY:                    The trouble with free care 
for all is that it is extraordinarily expensive and all the money goes 
to people who are relatively well off at the moment, none of it goes to 
poorer people, and more important none of it goes to the improved services, 
which is really what the, the old people in the greatest need are crying 
out for.

RACHEL SQUIRE MP:            The present system hits hardest 
those who worked all their lives, paid their taxes and national insurance, 
put some money aside, many sought to buy their own, own home, but are just, 
aren't particularly well off, but are just two or three pounds a week maybe 
above the line on which they could qualify for free care or for falling 
below the means-tested limit.

DIGNAN:                    Here at the Department 
of Health, ministers and their civil servants have been trying to distinguish 
nursing care from personal care. Those who are sceptical of ministers' 
motives believe the whole exercise is being driven by the Treasury just 
across the road. The aim, it's argued, is to find a definition of nursing 
care which minimises the cost to the Government. 

PAUL BURSTOW:                I think the Government is 
not so much in search of a, a definition. It's in search of the way to 
spend as little money as possible on this problem. The definition they're 
likely to be going for will be so tight that anything really to do with 
the basic intimate care of a person whether it be bathing, helping them 
get dressed, helping with feeding and so on, essential elements of what 
people would think should be provided free will not be provided free." 
 

DIGNAN:                    Many frail elderly people, 
like this man, live in their own home. The Royal Commission wanted more 
money to be spent on helping people stay in their own homes. But the minority 
claimed this would be impossible if all care in nursing homes was made 
free.
   
LORD LIPSEY:                The most severely disabled 
old people living at home get just four hours help a week from their local 
councils with their care. That's palpably inadequate for all their various 
needs and that should be greatly increased. But the money to pay for it 
has to come from somewhere, and it has to come in my view largely from 
Government, and that's why we can't afford to do that and to do free care 
too. 

DIGNAN:                    In York one solution to 
the problem is being tried out by the Joseph Rowntree Foundation. When 
you buy a home at Hartrigg Oaks, you are guaranteed nursing care - if you 
ever need it - at no extra cost. The idea is to take away the anxiety many 
elderly people feel about how they will pay for care. And, importantly, 
the emphasis is on care in your home. A year after buying her property, 
Verity Grob had a stroke. After a spell in hospital and Hartrigg's care 
centre, she's now back at home because help is available to her.

VERITY GROB:                After being away months, in 
hospital for months and then over there for months, it was wonderful to 
get back to my own, my own bed which I was longing to get back to.
   
DIGNAN:                    Lunch is only a short walk 
away for those who want it. Hard-pressed local authorities can't provide 
the kind of service on offer here.

UNNAMED MAN:                "Well. look, I've got ten 
pounds."

UNNAMED WOMAN:            "It's alright I've got plenty of 
change."

DIGNAN:                    But inadequate home care 
does not save money overall, it's argued.
     
RICHARD BEST:                People are getting admitted 
into hospital much earlier than they might have done, the number of emergency 
admissions of older people has gone shooting up. People who just have something 
relatively minor like flu can get into serious difficulties if they are 
not getting attention and help in their own home. .That is a great cost 
to the state. So there are false economies in not spending money on care 
in the community which is where we think the main emphasis of new spending 
should be.

DIGNAN:                    The first signs of sunshine 
have brought the veterans of bowls out on to the green. Cornwall has a 
large elderly population. If they are to live at home as they get older, 
it will require higher levels of taxation. That's what happens in Scandinavia. 

     
HINCHCLIFFE:                We have a situation in this 
country where there's a consensus around low taxation. We get lower public 
services, we get - we lessen the ability to enable people to remain independent, 
to have choice in old age or in disability, that is afforded to people 
in other countries such as Denmark.

LORD LIPSEY:                Something like sixty per cent 
of national income goes in taxes. Six pounds in every ten you earn going 
in taxes, in the Scandinavian countries, um and it really doesn't seem 
that that is politically possible in this country and therefore we face 
hard choices that they don't face as to whether it's to be better services 
or free services.

DIGNAN:                    Making available to all 
the care on offer at this nursing home may well require Scandinavian tax 
levels. The minority members of the Royal Commission suggested an alternative 
- private insurance. The better off could then pay for their care and leave 
money to their children.
   
LORD LIPSEY:                It's absolutely right if people 
want to leave an inheritance to their children that is their, their right. 
What is not reasonable is that they expect the State to subsidise that 
inheritance by making all their care free. If they want to leave an inheritance 
they can do so but they should insure themselves privately for their care 
costs so they can leave their money in full to their children if that's 
what they wish.

SQUIRE:                    In that most privatised 
of health care markets the United States, only five percent of the population 
have insurance to deal with long term care. You're talking about very expensive 
premiums and frankly you're talking about a market that isn't interested 
in anyone who has any kind of blemished health record.
  
DIGNAN:                    Retirement brings with 
it new opportunities, the chance to learn new skills. At the last election 
many elderly voters changed their political colours. But they've been disappointed 
with recent pension increases and fear the Government may fail to design 
a fairer system for paying for care in old age.
  
UNNAMED WOMAN:            "I changed from being a Conservative 
and I voted Labour for the first time expecting, you know, to get a better 
deal from them because they promised so much but unfortunately it hasn't 
materialised."

SQUIRE:                    Their perception and their 
feeling is we don't feel that we've received what we paid for all our working 
lives and I think that section of the population who have a lot of votes 
will be looking very, very keenly at what the Government's decision will, 
will be.

DIGNAN:                    Even though many elderly 
people try to keep fit and active, they may still need care one day. When 
it set up a Royal Commission, Labour raised expectations it would address 
their anxieties over how to fund long term care. If Labour disappoints 
those expectations it risks sending many older voters back to the Conservatives.