The blue touch paper needs to be lit on the healthcare funding debate

It's now over six months since Sir Stewart Sutherland stood up, opened his bag and let out the secrets of his report into long-term care. In response Frank Dobson promised an "informed debate" about the contents.

Six months have passed since then and Frank Dobson is now moving on. So far as I have been able to see, no one seems to have even found the blue touch paper needed to ignite a debate, far less light it. And anyway, wasn't the report itself meant to be the informed debate?

Whilst John Hutton – the "Minister with the poisoned chalice" – confirmed during the Labour Party Conference that the report is not buried and will receive a full and complete response, he offered no clue at all to Government thinking, so no opportunity at all for anyone to engage in debate.

The Minister even went so far as to say that "the taxpayer may be asked to shoulder significant additional responsibilities" but again with no indication of how, or when, or for what.

Frank Dobson and his colleagues have flown the odd kite, but realistically, they haven't said anything concrete. In the absence of any confirmed action, let's take a look at the possible options open to Frank Dobson (or his successor) and how they would affect the individual.

Straight away, let's assume that the Government is not going to say that all long-term care is going to be free in future.

That would be a move in totally the opposite direction to other welfare developments and, wasn't an option considered by the Royal Commission at all. It has to be regarded as a non-starter. So what options are we looking at?

Maintain the status quo
Frank Dobson and his colleagues are on record as saying that the present system of paying for long-term care is unsatisfactory and has to change. As there are generally no U-turns in politics, we ought to be able to rule this one out. On the other hand, if you don't do anything you can't make a mistake and politicians don't make mistakes either, so maybe we shouldn't ignore this one totally.

If the system does stay unchanged, people needing care will continue to have to pay for it themselves, and a long term care insurance plan can help them raise the money to do that.

Part funding
The Royal Commission suggested that the Government pay some additional costs for the individual – either "personal care" (the majority), or "nursing care" (the minority). Yes, this solution costs the taxpayer, but so will any change in the system. After all, wasn't that what people thought the Royal Commission was to be about – how and where the Government would pay more?

Either option means that the person needing care feels that the Government is doing something for him. However, there are still some, albeit reduced, costs which the individual has to provide himself. These can be taken care of by arranging an insurance plan to cover the cost.

By way of clarification, it's worth looking at what the definition of personal and nursing care is. "Personal care" is care which requires bodily contact – washing and help with the toilet for example. "Nursing care" is care which requires a nurse to provide it – medication or bandaging for example.

"Social care" -– someone coming in to do the shopping and cleaning – is not on the agenda at all, and is another good example of what the Government will not, but long term care insurance plans will, pay for.

Capped care
Another option is to share the care costs by virtue of the Government picking up care bills after a certain point in time.

So the individual pays for his care for two or three years and the Government pays after that.

Long-term care insurance plans are already available to fit in with this solution.

Change the means testing limits
The means test is where the whole long-term care debate started way back in 1995. People did not want to sell their houses to pay for care, but were faced with a means test which protected only £10,000 of their assets from care costs (and still does).

A means test limit of £60,000 would allow everyone to keep an extra £50,000 of their assets for their families. However, as a solution it won't satisfy those organisations and lobby groups which want to see the "real care issue" – quality, quantity and the unmet demand for care tackled and so won't silence the critics concerned with these issues.

As at present, insurance plans would continue to protect assets from care costs so we know that insurance has a role and we know that it will fit with whatever solution the Government decides on in the end.

Recognising the role of insurance
Having been pretty cool towards the role of insurance in his report, Sir Stewart Sutherland himself has now recognised the importance of private insurance. He has accepted that it will fit in with the recommendations he made and does have a place in providing funds for long-term care costs.

In fact, insurance plans have led the way in more than one area in which Government is particularly interested. They provide plan holders who qualify for benefits with a one-stop shop – one point of contact which accesses all the care and help services wanted.

And in addition – to paraphrase one PM paraphrasing another, "the plan holder gets the care he chooses, when he chooses, where he chooses and from whom he chooses." Food for thought!

Yet, six months down the line, we seem no nearer finding out what the Minister has in mind than we did when Sir Stewart sat down after his March 1 press conference.

What we must do is continue to emphasise the vital role that long-term care insurance plays and the increasingly important role it will play as and when decisions are made.

For our part, PPP lifetime care believes that the Government should look very closely at the majority report if it wants to adopt a system which the electors will accept and which individuals can build on by arranging long-term care insurance plans to complement it.