´óÏó´«Ã½

With almost a quarter of the population likely to be over 65 within 20 years, how we pay for the care of our ageing population is a problem that successive governments have failed to solve. It's set to become even more pressing as Britain's baby boomers – who've so far lived through a golden era of full student grants, final salary pensions and property price rises – start turning 65 next year.

With 25 per cent cuts predicted in public services across the board and with three in four over 65s needing care at some point (Source: Dept of Health) – they'll find the public purse is almost empty and with elderly care provision not protected from the cutbacks, less will be expected to do much more in future.

Details of a new commission to consider how to fund elderly care have been unveiled by the Department of Health and, in a special authored report for Panorama, Joan Bakewell, until recently the Government-appointed Voice of Older People, has been exploring how we're facing up to old age.

Among those she met is widow Marian Croucher, 81, who needs round-the-clock care. Mrs Croucher, a former school secretary, mother of three and grandmother, has dementia. Her daughter Cathy Morgan, first noticed tiny changes in her behaviour a few years ago.

She tells Joan: "I noticed mum wasn't quite right, and when I'd go into the kitchen I noticed that things weren't washed up properly or things were put in different places and not where they should be, and, I just noticed mum was deteriorating."

Last October, Cathy gave up her home in London and, along with her husband and son, moved down to Somerset to look after her mother. After a fall, Marian was hospitalised and the family were told she needed full time residential care. Now Cathy is selling her mother's home of 30 years to pay for her care. The nursing home she's chosen for her mother does not have a contract with the local council, so Cathy has to fund the fees of nearly £900 a week herself.

Cathy doesn't begrudge paying for her mother's care, even though she and her brothers will not now inherit the house from their mother, but but is disillusioned by the system. She tells Joan: "I mean, all their lives mum and dad have worked, you know, my dad had worked, my mum had worked, they'd paid into the system, they'd paid into the social funding, everything, and I think they expected to be looked after in their old age."

Many people end up feeling the same. People think the NHS is there for us all, but social care – the help with washing, cooking and dressing – almost always has to be paid for. If you end up needing residential care the average length of stay is just two years but for those with dementia, like Marian, that can be much longer. Cathy has worked out that the sale of her mother's home will fund just over three years of care.

In England anyone with assets of more than £23,250 usually has to pay for any social care. When it comes to long-term residential care, that includes property.

Richard Humphries, Senior Fellow, The King's Fund, thinks it is about fairness across the generations. At present there are four people of working age for each retired person but, by 2060, that's expected to change to just two, so the number of people working to pay for social care is decreasing.

He tells Joan: "There is an important question here – just how fair is it to dump all of those costs on to the tax payer, who in many cases will be poorer than the people whose care they are paying for through their taxes? So there are some real issues about fairness across the generations here.

"Should you have to sell your house to pay for care? I think most people would say well: 'No, that's terrible'. If, on the other hand, you said look, if you have got a house that is worth £200,000 ... £400,000 and you need long-term care, would it be reasonable, when you longer need that house?"

Michelle Mitchell, Charity Director Age UK, tells Joan: "We face a crisis in England today about our social care provision. We have an ageing population so more people need that help and support when they are frail and vulnerable and what we're finding is local authorities who are strapped for cash saying they are not getting enough money from central government are withdrawing those services at a time of great need."

But, as Joan discovers, there are alternatives and some people are opting to help themselves before they need care. New Oscott is a retirement village in Birmingham. It has been developed in a partnership between Birmingham City Council, a housing association and The ExtraCare Charitable Trust. It is the first of five such villages proposed across the city. It offers 260 mixed tenure, affordable homes with up to 24-hour assessed care available for those residents who require support. It means buyers will never have to sell up as all the care is provided on site. The price they pay for their flat is what they can leave to their family on their death when the property is sold. Any increase in value will be ploughed back into the development.

Olive and Chris Quinn sold their family home of 31 years to move to the village. They take Joan on a tour of the village and Chris tells her: "We bought into a way of life. There's entertainment, whatever you are interested in – it's going on downstairs."

Olive adds: "When people get older, no one to care for them, they end up in homes. They sit round four walls and that's it, that's their life. That is not going to happen here."

The future is unclear but there are some positives. Dorset – where 29 per cent of its residents are already retired, compared to 19 per cent in the UK as a whole – is a glimpse of the future. Dorset County Council is leading the country in finding new ways to provide what it believes to be better care for less money. Its reablement programme – where older people get short bursts of concentrated care aimed at returning them to full independence – is expected to be rolled out across the country.

Andrew Archibald, Head of Older People's Services, Dorset County Council tells Joan: "Traditionally domiciliary care services have gone into people's homes and done things to them. This is much more about doing things with them and doing things that enable a person to get to the point where they don't need that service."

Rose Collis, 88, fell and broke her arm and has been getting visits from the team. Both Rose and her daughter Pat Raison are very happy with the service.

Pat tells Joan: "I just think they're treating her as things come along, not making it seem anything different from the daily routines."

Dorset has found that three-quarters of those people talking part in the reablement pilot scheme needed less care afterwards.

Joan Bakewell says: "I feel optimistic that the future could come right. I can see we're coming up with innovative ways of looking after our older citizens. It would be terrible if damaging cuts ruined the good work."

She adds: "This is a matter for everyone: we will all be frail one day. Right now there is a real danger of neglect."

Notes to Editors

Panorama – The Generation Game is broadcast at 8.30pm on Monday 26 July.

PH