TY - JOUR T1 - Funding for social care: the continuing conundrum JF - British Journal of General Practice JO - Br J Gen Pract SP - 600 LP - 601 DO - 10.3399/bjgp11X601226 VL - 61 IS - 591 AU - Stephen Gillam Y1 - 2011/10/01 UR - http://bjgp.org/content/61/591/600.abstract N2 - The question of how to fund long-term care of older and disabled people has long confounded politicians across the developed world. While health care in England has been ‘free at the point of delivery’ since 1948, social care has been subject to means-tested charges. Last autumn the coalition government asked Andrew Dilnot, an Oxford economist, to come up with new proposals. Dilnot's commission has recently reported.1 Has he anything new to propose and why does this matter to general practice?Long-time observers of social policy will be familiar with previous reviews,2–4 notably the Royal Commission on Long Term Care which reported in 1999.2 The failure to make progress is easily explained. Calls for free personal care, whatever the situation north of the border, were never likely to garner support from the English exchequer. (Following the introduction of free personal care in Scotland in 2002, there has been a substantial increase in demand for care which cannot be explained by demographic trends, higher rates of disability, or reductions in informal care.5) Dilnot thinks that the state should pay more for social care; but so must we. In specifying how — and with a degree of realism — his report represents an advance.Reading earlier reports, one is struck by the commonality of concerns and phraseology. All parties agree that the current system is ‘confusing, unfair and unsustainable.’1 Many people's last years are blighted by fear of penury. They are unable to plan ahead to meet their future care needs. This is the only area where people cannot pool their risks and protect themselves against … ER -