Social care: Four ways to reform the system

An alternative approach is to ensure that everyone who is eligible, based on their needs, should get state-funded personal care that is free at the point of use.

This would be provided free regardless of an individual’s means and whether it was received by an elderly person in their own house or a residential care home.

Scotland has implemented such a system.

However, it’s important to note that personal care takes in things like helping frail elderly people wash and dress and go to the toilet.

But it does not include accommodation, food and everyday living costs which are known as “hotel costs”.

In Scotland people in care homes still pay their own hotel costs which are subject to a means test.

The Health Foundation think tank estimates that implementing a Scottish-style system in England would cost £7.5bn a year by 2036.

Like Scotland, Japan and Germany have systems which base entitlement to personal social care mainly on people’s care needs rather than their ability to pay.

Japan and Germany though have a mandatory long-term care insurance system which is funded through contributions from workers and employers.

Both countries also do not usually cover the full cost of personal care so individuals are responsible for some of the expenses.