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Dr Alf has hit the nail on the head when he says that Adult Social Care should be subsumed by the NHS and removed from inefficient and corpulent local authorities.

The deeper problem is however longevity, morbidity and cost.

People in this country do not want to look after their elderly parents and want someone else to deal with it.

They do not want to pay for this to be done, they want to inherit all that person’s money and property and secretly they wish that the Adult Social Care recipient would go away, gift all their estate to them inter vivos, live 7 years, die and be cremated at the lowest possible cost.

People who are not Adult Social Care recipients or ill imagine that they are immune from the possibility of deteriorating health or injury causing mental incapacity.

Furthermore, many of them imagine that “the State will pay” in the event that this happens and look after them for nothing until the Grim Reaper strikes or their affliction sorts itself out.

Local Authorities of which there are too many, are incapable of running their own affairs efficiently and outsourcers, like Serco, who run my own County Council, Hertfordshire, have taken over Adult Social Care on the basis of “aggressive re-enablement” of Adult Social Care recipients based on a series of flawed actuarial assumptions which should have been identified by the Authority and its service directors but was not.

The figures are stark.

An Adult Social Care recipient of retirement age will live on average 3 years and a good proportion will develop dementia which has no official cure and is a labour intensive condition to manage.

At an average of £600 gbp per day in a home, we are looking at a bill of £218,400 per year.

Local Authorities provide £368 per day currently and even if that figure was to rise to £500 gbp per day via merger with the NHS one is left with a shortfall of £36,500 gbp per year or £109,500 over 3 years.

For those with equity in their houses the solution will be to sell up and clear the shortfall if there is enough left after Capital Gains tax(if applicable).

However, the present threshold of £23,500 gbp effectively means that all Adult Social Care recipients other than the most impoverished,will pay in full or have the money extracted from their estates.

Increased longevity will of course throw these figures out and increase the shortfall so more radical solutions are needed:

1) A long-term care premium to be added to NI for everyone who is still working

2) Euthanasia (effectively a “Logans Run ” solution to terminate the lives of those who are too costly to look after

3) Shipping Adult Social Care recipients out to Goa and Thailand as the Germans are already doing in order to reduce the costs of their care

4) A cure for dementia and debilitating diseases

There are currently trials of a patented biscuit going on as we speak and results look promising,however more time and work will be required before it can be regarded as a cure for dementia and this does not deal with the other big problems surrounding this issue,namely obesity, depression, arthritis and diabetes

5) A death tax funded by compulsory long-term care insurance

6) Variable taxes on foods and the use of robots in care homes

7) Aggressive re-enablement for those who can benefit from it and enforced prescribed exercise and diet, stomach stapling and gastric bands for the morbidly obese

8) Educating the public to care for their own elderly on the basis that there is no longer a free lunch and that what they do to their parents will be seen by their children as the blueprint for what will happen to them

The immediate problem is very severe and cannot be paid for out of existing tax revenues so 2) and 3) need to happen straightaway as people are not prepared to pay higher taxes and there are too few people working as a proportion of the total population.

Longer term variable taxes on foods, aggressive re-enablement and 5) plus prescribed exercise,Tai Chi,vitamin supplementation and public education are required to ensure that people take responsibility for their own health.

For those who refuse to change,unless they lack mental capacity the message will have to be that “You are on your own”.

John Gelmini