As the dust settles following the launch of the care green paper in July, the ambition and the gaps are clearer.

Creating a national care service is ambitious. It could put care on a par with the NHS. Making care a universal service that everyone has a stake in and everyone benefits from would certainly make a big difference. The Government has recognised that we have to address the care implications of our ageing society. We simply can’t do nothing and ignore the needs of this and future generations of older people.

Bold proposals in ‘Shaping the Future of Care Together’ to end the postcode lottery in care and make paying for care fairer for everybody therefore have to be welcomed. The proposals meet many of Counsel and Care’s tests for a new system which must be simpler, fairer, consistent, transparent and flexible, meeting the needs of older people wherever they live.

Counsel and Care particularly welcomes:

• the proposal for a National Care Service with a universal entitlement to care and a national assessment and portability to end the postcode lottery
• much better provision of information, advice and advocacy to give older people and carers greater choice and control
• closer joint working between health, housing and care services to make the best use of resources
• the emphasis on promoting healthier later life, investing in prevention and supporting older people earlier through schemes like telecare to improve quality of life and save money
• support for better regulation, improved training and career development for the care workforce to deliver better quality care.
• the proposal for a universal deferred payment scheme to help people meet the accommodation costs of residential care.

The proposal to merge Attendance Allowance with care funding is going to create huge debate. Attendance Allowance is popular with millions of older disabled people because it provides financial support towards the extra costs of disability, such as heating or washing, but gives freedom of choice and flexibility over how these needs are met, is accessible regardless of income or savings and not subject to the postcode lottery. For those living on low incomes, the allowance offers a passport to other essential benefits.

What is surprising for a green paper on funding care is the almost complete absence of financial figures and modelling. There is no clear indication what a national care service and the extra demands of our ageing population might cost; how much would be paid by the government; and critically what individuals would get for their contribution.

What can’t be ducked though is that care will cost us all more. So we need to find new ways to pay for the growing bill. Any new funding system must be fairer, simpler and transparent for all.

The green paper presents some radical long-term proposals to pay for the better care older people and their carers urgently need, particularly for the growing number of older people with dementia, disabilities and long-term conditions.

Of the three funding options, I support the comprehensive option as being the simplest way to share the risks and costs of care. Everyone would get the care they need in return for a one-off contribution.

What needs to be debated is how that contribution could be made in a way that is fair. I have argued for some time that a care duty on people’s estates would be the best way to pay for care – we already have a collection mechanism and the level of payment could reflect an individual’s wealth, rather than everyone being required to pay the same lump-sum. A care duty could also be linked to the proposed universal deferred payments mechanism for accommodation costs.

Politicians of all parties should work together in the big care debate, launched in the care green paper, to build a national consensus around tackling one of the biggest issues facing our ageing society.

Stephen Burke is Chief Executive of Counsel and Care, the national charity working with older people, their families and carers to get the best care and support. www.counselandcare.org.uk

He will speaking about the green paper at the BSG Annual Conference on 2 September.