Health secretary Andrew Lansley’s decision to launch groups designed to champion views of patients leads to complaints.
Andrew Lansley’s plans to put the patient at the heart of the NHS have been labelled as “confusing, vague and insulting”.

The health secretary pushed ahead with HealthWatch, the new body to champion patients’ views, despite ministers being forced to apologise and withdraw a consultation on the new watchdog. Ministers had conceded that their original plans had been conceived in haste and without proper consultation.

But Lansley announced that 75 local HealthWatch groups were in place. HealthWatch is supposed to replace local patient involvement networks, known as LINks, in 2012 – bringing “real local democratic accountability and legitimacy” to the NHS “for the first time in 40 years”.

Malcolm Alexander, chair of the National Association of Local Involvement Networks Members, said that, instead of increasing budgets to fund the new bodies, cash was being cut even though the government was asking local groups to take on a range of new responsibilities, such as promoting the integration of care and health services and improving choice for patients, without extra money.

Alexander said: “It’s pathetic. The consultation had a figure of £20,000, which was confusing and looked like a cut. Then that was withdrawn. Our figures show that networks are having their budgets cut this year by 24% on average.”

He said there was no start-up funding for local HealthWatch “pathfinder” groups and no ringfenced money in local authority budgets to run the new bodies.

The money for HealthWatch comes out of local council budgets, which are being cut by 30% over the next four years. “Our own research asked whether these new policies were evolution or abolition. It looks like abolition to us,” he said.

Sally Brearley, senior research fellow in patient and public involvement at King’s College London, who sat on the prime minister’s Future Forum which re-examined the health reforms, said she “shared the concerns”.

“There’s a lot of extra work to develop these new HealthWatch bodies and they are supposed to be monitoring the NHS as services are being cut and finances are under strain. It’s a real issue.”

A Department of Health spokesperson said the criticism was misleading.

“The government has not cut funding, and has no plans to do so – in fact, we retained the current level of funding at £27m, rising in line with inflation, for the spending review period.”

From: http://www.guardian.co.uk/andrew-lansley-condemned-healthwatch

Hip replacements, cataract surgery and tonsil removal are among operations now being rationed in a bid to save the NHS money.
Two thirds of health trusts in England are rationing treatments for “non-urgent” conditions as part of the drive to reduce costs in the NHS by £20bn over the next four years. One in three primary-care trusts (PCTs) has expanded the list of procedures it will restrict funding to in the past 12 months.

Examples of the rationing now being used include:

• Hip and knee replacements only being allowed where patients are in severe pain. Overweight patients will be made to lose weight before being considered for an operation.
• Cataract operations being withheld from patients until their sight problems “substantially” affect their ability to work.
• Patients with varicose veins only being operated on if they are suffering “chronic continuous pain”, ulceration or bleeding.
• Tonsillectomy (removing tonsils) only to be carried out in children if they have had seven bouts of tonsillitis in the previous year.
• Grommets to improve hearing in children only being inserted in “exceptional circumstances” and after monitoring for six months.
• Funding has also been cut in some areas for IVF treatment on the NHS.

The alarming figures emerged from a survey of 111 PCTs by the health-service magazine GP, using the Freedom of Information Act.

Doctors are known to be concerned about how the new rationing is working – and how it will affect their relationships with patients.

Birmingham is looking at reducing operations in gastroenterology, gynaecology, dermatology and orthopaedics. Parts of east London were among the first to introduce rationing, where some patients are being referred for homeopathic treatments instead of conventional treatment.

Medway had deferred treatment for non-urgent procedures this year while Dorset is “looking at reducing the levels of limited effectiveness procedures”.

Chris Naylor, a senior researcher at the health think tank the King’s Fund, said the rationing decisions being made by PCTs were a consequence of the savings the NHS was being asked to find.

“Blunt approaches like seeking an overall reduction in local referral rates may backfire, by reducing necessary referrals – which is not good for patients and may fail to save money in the long run,” he said. “There are always rationing decisions that have to go on in any health service. But at the moment healthcare organisations are under more pressure than they have been for a long time and this is a sign of what is happening across many areas of the NHS.”

According to responses from the 111 trusts to freedom-of-information requests, 64 per cent of them have now introduced rationing policies for non-urgent treatments and those of limited clinical value. Of those PCTs that have not introduced restrictions, a third are working with GPs to reduce referrals or have put in place peer-review systems to assess referrals.

In the last year, 35 per cent of PCTs have added procedures to lists of treatments they no longer fund because they deem them to be non-urgent or of limited clinical value.

Some trusts expect to save over £1m by restricting referrals from GPs.

Chaand Nagpaul, a member of the British Medical Association’s GPs committee, said he was concerned about PCTs applying different low-priority thresholds and rationing access to treatments on the basis of local policies.

He said the Government needed to decide on a consistent set of national standards of “low priority” treatments to help remove post-code lotteries in provision. “Patients and the public recognise that with limited resources we need to make the maximum health gains and so there needs to be prioritisation. What is inequitable is that different PCTs are applying different thresholds and criteria,” he said.

A Department of Health spokesman said: “Decisions on the appropriate treatments should be made by clinicians in the local NHS in line with the best available clinical evidence and Nice [National Institute for Health and Clinical Excellence] guidance. There should be no blanket bans because what is suitable for one patient may not be suitable for another.”

From: http://www.independent.co.uk/cataracts-hips-knees-and-tonsils-nhs-begins-rationing-operations

Patients will routinely be able to consult with doctors over the internet from their own homes within “a year rather than a decade”, the medical director of the NHS has said.
Sir Bruce Keogh said that using emerging video internet technology he could envisage an NHS that was “available 24-7″.

High-speed broadband – essential to internet video calling – could allow people to consult international experts or to take advantage of out-of-hours care provided by overseas doctors in another time zone, he said.

Such technology would lessen the need for a “geographical connection” between GPs and their patients, while it would also enable doctors to conduct what he called “virtual ward rounds”.

Sir Bruce, who as a cardiac surgeon persuaded his colleagues to make their success rates public, was speaking at the Government’s launch of its plans to make all state data available online.

He said the NHS had to adapt because “young people won’t put up with having to travel to a doctor and wait 20 minutes when they can just use the web to talk directly to a doctor”.

Patients for whom such “telehealth” services might be useful included those who needed to see a specialist about a chronic condition such as diabetes, or those with visible conditions like skin complaints.

Some doctors are already trialling services online, but in rural areaswhere the benefits would be most apparent, poor broadband infrastructure is holding back progress.

Sir Bruce acknowledged that the NHS had yet to lay out a “national vision” for digital access, but he said that it would happen in the future.

As well as being better for patients, he argued that in the long term it would be cheaper and more efficient for the NHS.

In Northern Ireland, he said, a group of neurologists had found using new technology was “cheaper and the patients like it more”.

However, he also acknowledged that his plans would “open up a whole heap of financial issues”.

High-speed broadband connections are already being used to monitor older people who are able to stay in their own homes with remote supervision.

The new telehealth technologies are one reason why the Government has allocated £530 million to spend on improving broadband in the UK by 2015.

Frances Maude, Cabinet Office Minister, said that plans to release data about all NHS performance, including GPs as well as surgery, would allow patients to be more selective about their treatment.

The British Medical Association is leading a project to present data on GP performance.

The Government is set to announce how superfast broadband networks, essential for high-quality video consultations, will be funded next week. Each county is set to be allocated an amount of money based on the geographical challenges it faces.

http://www.telegraph.co.uk/Doctors-to-see-patients-by-video-link.html

Government policies for treating drug addicts in England are flawed and “doomed to failure”, a think tank says.
The Centre for Policy Studies says rehabilitation is a better use of the £3.6bn now spent on treating users with drug substitutes like methadone and keeping them on benefits each year.

But it says plans to reward groups which treat addicts so they can return to work are open to manipulation.

The Department of Health said it aimed to get users “off drugs for good”.

The coalition government wants to change the way drug addiction is tackled, with more people with problems diverted away from prison and into treatment as part of what it calls a “rehabilitation revolution”.

Part of this involves rewarding treatment providers who show addicts have improved their health and employment prospects.

A report from the right-of-centre think tank, which has links to the Conservative Party, says these payment by results schemes were being run by the very organisations “responsible for the current failure of policy”.

It says the current annual cost of maintaining treatment for 320,000 problem drug users is made up of £1.7bn in benefits, £1.2bn for looking after their children and £730m for prescribing the heroin substitute methadone.

Kathy Gyngell, Centre of Policy Studies: “The Department of Health has been paying 153,000 people to be on methadone”

The think tank calls for “a real transfer of power from large distant organisations to small innovative providers” for rehabilitation.

It says such units have a better chance of getting addicts off drugs completely, adding: “There is one simple measure of success: That of six months abstinence from drugs.”

According to the report’s author Kathy Gyngell, chairwoman of the prisons and addictions policy forum at the CPS, prescribing methadone to addicts delays their recovery.

She told the BBC: “The state is subsidising people to be any number of years on methadone, which has turned out not to be a cheap option and will only subsidise the tiniest proportion – 2% – to go into a rehabilitation unit that would actually free them from dependency and allow them to live their life.”

A Department of Health spokesman said: “The 2010 Drug Strategy is fundamentally different from those that have gone before.

“Instead of focusing primarily on reducing the harms caused by drug misuse, our approach will be to go much further and offer every support for people to choose recovery as an achievable way out of dependence.”

He added: “Work is under way to support local recovery systems tailored to the needs of communities, many of which are already showing positive results.”

From: http://www.bbc.co.uk/news/uk-13826759

Health Direct has for a long time noted the costly failure that is the current policy on drugs. On August 02, 2006 in Risks of taking drugs compared- Scientific review of dangers of drugtaking- Drugs, the real deal

we reproduced the first ranking based upon scientific evidence of harm to both individuals and society.

It was devised by government advisers – then ignored by ministers because of its controversial findings.

The analysis was carried out by David Nutt, the then senior member of the Advisory Council on the Misuse of Drugs, and Colin Blakemore, the chief executive of the Medical Research Council.
http://www.healthdirect.co.uk/2006/08/risks-of-taking-drugs-compared.html

David Cameron has agreed to make changes to the plans for the NHS in England and insisted the government had not made “a humiliating U-turn”.
Ministers have accepted all the recommendations suggested by a panel of experts, including more controls on competition and a slower pace of change.

Doctors’ groups have broadly welcomed the revisions.

The NHS bill will now go back to the committee stage in the House of Commons to be scrutinised again by MPs before going through its House of Lords stages.

The prime minister’s official spokesman said he expected that to happen before the summer recess begins in July, and the bill to be on the statute book by the end of the current Parliamentary session.

That gives ministers until May 2012 to make it law.

On Monday – following a 10-week “listening exercise” – a panel of experts called the NHS Future Forum gave its recommendations on the changes needed to the bill.

They include:

• Reinstating the legal responsibility of the health secretary for the overall performance of the NHS
• Scrapping the primary role of the regulator, Monitor, to promote competition – and focusing on improving patient choice instead
• Relaxing the 2013 deadline for new GP commissioning arrangements to be introduced – a National Commissioning Board, based in Leeds, will control budgets until GP groups are “able and willing” to take over
• Strengthening the power of health and well-being boards, which are being set up by councils, to oversee commissioning and giving patients a greater role on them
• Retaining a lead role for GPs in decision-making, but boosting the role of other professionals such as hospital doctors and nurses alongside them

After criticism from medics and complaints from rebellious MPs, the Coalition will be hoping the dust will now settle over its NHS reforms.

If politics is the art of persuasion, then the test for Messrs Cameron, Clegg and Lansley is whether or not they have convinced people that the listening process has been, as the prime minister claimed, a sign of strength.

The government and many health professionals believe changes to the NHS are necessary to deal with the demands of the ageing population, cost of new drugs and lifestyle changes such as obesity.

Mr Cameron said those who described the reworking of the plans as “a humiliating U-turn”, or the listening exercise as “a big PR stunt”, were both wrong.

“The fundamentals of our plans – more control to patients, more power to doctors and nurses, less bureaucracy in the NHS – they are as strong today as they’ve ever been,” the PM said.

The health secretary has faced personal criticism for his inability to garner widespread support for the original bill, but the prime minister said he accepted full responsibility for what had happened.

“I am every bit as responsible as Andrew Lansley for the fact that we actually decided we could improve on what we already put forward,” Mr Cameron said.

The British Medical Association said it was pleased the government had accepted the Future Forum’s recommendations and addressed many of doctors’ concerns.

But it said more detail was needed on how commissioning of care would work in future and there must be “robust safeguards” to prevent competition of any kind destabilising the health service.

From: http://www.bbc.co.uk/news/uk-politics-13757380

Reforms to the NHS are already under way and working well doctors claimed after Andrew Lansley insisted that change was essential.
The head of a doctors’ group said that new bodies led by GPs have taken over from managers across the country, and are improving services to patients while saving money by reducing pressure on hospitals.

Dr Michael Dixon, chairman of the NHS Alliance, defended the changes by saying that neither medics nor the public wanted to be “pawns in the system” any more.

But he was warned that the power GPs appear to have been given to buy treatment is just an “illusion” and that they will end up merely rationing care in order to save money.

It comes after the Health Secretary, Mr Lansley, wrote in The Daily Telegraph that the NHS faces a £20 billion a year funding black hole unless it undergoes major surgery.

His Health and Social Care Bill proposes abolishing two tiers of management and allowing new GP-led bodies, called commissioning consortia, to buy £60billion a year of treatment from either state-run hospitals or private providers.

It has been bitterly opposed by much of the medical establishment on the grounds it may fragment services and lead to backdoor privatisation, and the legislation was put on “pause” by David Cameron after Liberal Democrats and peers threatened a rebellion.

But BBC Radio 4’s Today programme heard on Thursday that many of the changes are already happening on the ground, as clusters of GPs form consortia to take over from Primary Care Trusts.

Dr Dixon of the NHS Alliance said: “The evidence is in our report, showing over 20 commissioning groups already delivering better services for their patients and also delivering them more cost effectively.

“For instance, in this country the use of hospitals is disproportionately more than anywhere else in the world and those commissioning groups are showing how they can look after patients better in the community.

“If the commissioner is king, they can get the right balance of private and public and the right balance of competition and collaboration.”

Asked why more GPs were not in favour of the new regime, he replied: “To look after our whole patient population is quite an added responsibility and I think some people find that quite daunting.”

But he went on: “Many of us in this commissioning movement are fed up with being pawns in the system and fed up with our patients being pawns in the system.

“We feel that if we can make sure the NHS is delivering change and improvement from the bottom up instead of having to listen to targets coming down from Whitehall, that often don’t mean much to us, we can actually make a difference.”

From: http://www.telegraph.co.uk/GP-group-says-Andrew-Lansleys-NHS-reforms-are-already-working

David Cameron will commit to “five guarantees” on the future of the National Health Service in a speech designed to reassure critics of his controversial health reforms.The Prime Minister will promise to keep waiting lists low, maintain spending, not to privatise the NHS, to keep care integrated and to remain committed to the “national” part of the health service.

Such is the concern in Downing Street at the damage the issue of NHS reform is causing the Government, that Mr Cameron will put his reputation on the line with a personal pledge to protect its core values. It represents his boldest attempt yet to assuage criticism from his Liberal Democrat Coalition partners and from many health professionals over the impact of the reforms.

In his speech, the Prime Minister will admit that he is willing to act on their concerns after listening to the “profession and patients” during a two-month exercise which was held after Mr Cameron called for a “pause” in the Health Bill’s passage.

His “five guarantees” are designed to show the Prime Minister is committed to the NHS, and “he is hearing what is being said”, according to one source. Mr Cameron’s promise on integrated care is designed to ensure patients receive continuity of treatment, without having to explain their condition from scratch each time to different doctors.

It also means that nurses and hospital professionals will retain a role in commissioning services, and that not everything is transferred to GPs.

His commitment to the “national” part of the NHS represents a pledge to keep it as a universal service, free at the point of use. But Mr Cameron will also say that “no change” is not an option.

He will echo the words of Andrew Lansley, the Health Secretary, who wrote in last week’s Daily Telegraph about the threat to the NHS if it does not reform. He warned of a £20 billion a year funding black hole without reform.

Despite ring fencing health spending, Mr Cameron is expected to make clear that NHS services will be threatened unless there is reform because of the rising costs of drugs and an increasing elderly population.

Mr Cameron is likely to say that the Coalition’s reforms will see the NHS working better. He will point out that in Europe there are health systems which work more effectively.

The speech comes as ministers prepare to rewrite much of the Health Bill. At present the plans involve abolishing two tiers of NHS management and handing control of a £60 billion-a-year budget to groups led by GPs, who can choose to buy treatment for patients from local state-run hospitals or private providers.

This week, the Royal College of Nursing is expected to renew its call for nurses to have a key role on the GP commissioning boards. Mr Lansley will not commit to such a plan until he has heard from the Future Forum, which is reporting back on possible changes to the Bill.

Tomorrow, Mr Lansley, who has been subject to rumours that he is about to resign or be sacked over the issue, faces MPs in the Commons. He will defend the reforms, although he is prepared to see them substantially watered down. However, Labour will seize on stories circulating that Cabinet colleagues had suggested he would not last the year in his post.

Downing Street polling has painted a stark picture of the problems Mr Cameron faces over the NHS and Mr Lansley’s presentation of the plans over the past 12 months is being blamed.

Last week Stephen Dorrell, who was health secretary in John Major’s government, added to speculation that he will replace Mr Lansley. Asked on BBC’s Question Time about whether he would do a better job, he said: “I am going to plead the Fifth Amendment.”

From:
http://www.telegraph.co.uk/David-Cameron-puts-reputation-on-the-line-with-five-pledges-on-the-future-of-the-NHS

The children and families minister Sarah Teather has attacked the health service for failing some of the country’s most vulnerable young people.
Sarah Teather said the chance of a child receiving much needed speech and language therapy was a postcode lottery “between low and nil”, while the wait for a wheelchair could be “really long”.

Teather, who spent most of her own secondary school days in a wheelchair after suffering from a viral infection, said the health service “has not always been good at doing its fair share for children in this position”. Families were often left as the “piggy in the middle”, she said in an interview with the Guardian.

Health workers often agreed with parents that a child needed a wheelchair, incontinence pads or a form of therapy, but “nobody pays for it” and it fails to arrive, she said. This could severely impair a child’s chances in the future, she warned: “A six-month wait for speech and language therapy can be critical; an 18-month wait can be really critical.”

In some cases, by the time a wheelchair arrives, a child has grown too big for it, she said, adding that it was a “postcode lottery” to get basic equipment.

Government proposals, published in a green paper in March, would improve life for children with special needs and disabilities and their families, she said.

At the moment, children with severe or multiple health and learning disabilities receive a statement from their local authority. This covers only the services that schools are expected to give children, rather than those they need from the health service or social services.

The green paper proposes to replace the existing statement of special educational needs with a single care plan covering schooling, health and social services from birth to the age of 25. This would mean a child’s educational, social and health needs would be dealt with together. The plan would reflect a family’s needs and ambitions for the child’s future and would be continually reviewed.

The green paper also set out plans to give parents a personal budget to spend on services such as one-to-one tuition, laptops and wheelchairs.

“Rather than a family having to go to the council trying to bang down their door to get something, [the council] are coming to you saying, this is what we normally provide. The family then has a conversation about whether it is appropriate,” Teather said.

The government also plans to introduce into all schools a programme to help children with special needs improve at a faster rate.

Researchers found the Achievement for All programme helped nine- and 10-year-olds with special needs to learn reading, writing and maths three times faster than they were expected to under the national curriculum. Under the same programme, 14- and 15-year-olds with special needs made progress in maths and English that was equivalent to having an extra term of lessons in a year.

The programme, which has been piloted in 454 schools in 10 local authorities since 2009, works by setting pupils regular targets. Teachers and parents discuss progress three times a year for a minimum of 45 minutes. Children with special needs and disabilities are strongly encouraged to join school clubs and activities outside lessons.

Sonia Blandford, director of the programme, said it could reduce by 10% the proportion of children registered as having special needs.

From: http://www.guardian.co.uk/nhs-failing-vulnerable-young-people

Health Direct warns that as the bank holiday weekend approaches that the number of alcohol related hospital admissions in England has topped one million for the first time.
An NHS Information Centre report said admissions had increased by 12% between 2008-09 and 2009-10.

That includes liver disease and mental disorders due to alcohol abuse as well as some cancers, accidents and injuries.

The Department of Health will publish a new alcohol strategy later this year.

The number of admissions reached 1,057,000 in 2009-10 compared with 945,500 in 2008-09 and 510,800 in 2002-03.

Earlier this year the charity Alcohol Concern predicted the number of admissions would reach 1.5m a year by 2015. It estimated that would cost the NHS £3.7bn a year.

Tim Straughan, chief executive of the NHS Information Centre, said: “Today’s report shows the number of people admitted to hospital each year for alcohol related problems has topped 1m for the first time.

“The report also highlights the increasing cost of alcohol dependency to the NHS as the number of prescription items dispensed continues to rise.

“This report provides health professionals and policy makers with a useful picture of the health issues relating to alcohol use and misuse. It also highlights the importance of policy makers and health professionals in recognising and tackling alcohol misuse which in turn could lead to savings for the NHS.”

Professor Sir Ian Gilmore, the chair of the UK Alcohol Health Alliance, said: “This confirms doctors’ impressions that the health harm from alcohol continues to rise.”

“While total alcohol consumption has fallen in recent years it is likely that the number of abstainers in England is increasing, but those who do drink continue to do so in a harmful and destructive way.”

The body which represents drinks manufacturers in the UK, the Portman Group, expressed surprise that admissions had increased at the same time as alcohol consumption had decreased.

David Poley, chief executive of the Portman Group, said: “If the hospital admissions data are robust, they clearly put paid to the argument that measures to reduce overall alcohol consumption are effective in reducing harm.

“The report shows that the proportion of people misusing alcohol is falling. We just need to find a way of persuading and educating this hard core of misusers who account for these admissions to drink responsibly.”

Alcohol Concern said the latest set of figures were alarming but that early detection of alcoholism contributed to the increase.

Its director of policy and communications, Nicolay Sorensen, said: “More people than ever before are drinking in a way that is harming their health and it’s a serious public health problem. It’s one of the biggest public health problems facing the country.

“In addition, the NHS has been doing some great work to identify people that have alcohol problems and so some of the increase is due to better identification and better referral.”

Public Health Minister Anne Milton said: “These statistics show that the old ways of tackling public health problems have not always yielded the necessary improvements.

“We are already taking action to tackle problem drinking, including plans to stop supermarkets selling below cost alcohol and working to introduce a tougher licensing regime.

“We will also be publishing a new alcohol strategy later this year.”

Rates of alcohol-related hospital admissions came down in the past two years in Scotland, after increasing for a decade. In Wales, figures for up to 2006 showed increasing admission rates and in Northern Ireland the total number of admissions increased year on year since 2006/07.

From: http://www.bbc.co.uk/news/health-13559455

Britain faces one of the largest bills for elderly care of any leading industrialised nation, with rising costs threatening to undermine the bonds between parents and their children, a major international study has found.
Research to be presented this week suggests that a combination of low birth rates and rising life expectancy will force the UK to spend an extra £80 billion each year on pensions, long-term care and the health service by 2050.

The mounting costs will leave working adults facing a triple blow of higher taxes, longer working lives and less inherited wealth as their parents are forced to sell property to pay for care, the study said.

The Organisation for Economic Cooperation and Development (OECD), which conducted the research, warned that workers may be unable or unwilling to take time off to look after elderly relatives or pay more tax to support rising numbers of older people in future.

In order to preserve goodwill, the elderly will have to stay in work for longer and save more towards their own private pensions so that they are seen to be fending for themselves, the study said.

In an interview with The Daily Telegraph, the OECD’s leading pensions analyst warned that Britain’s ageing population, combined with already high rates of family breakdown, meant relations between the old and the young are under threat.

Edward Whitehouse, the organisation’s head of pensions policy analysis, said the UK was projected to have “among the highest long-term care expenditures by 2050” of any of the 28 countries examined.

“I don’t think that future governments will be able to afford that, which brings us on to how we are going to pay for that system,” he said. “The money has got to be found from somewhere. It is going to have to be higher taxes or cuts in public spending on other programmes.”

The research suggested that by 2050, the UK will be forced to spend 21.6% of GDP on long-term care, pensions and health services to cope with the rise in elderly people requiring state assistance.

This is an increase from 16.5% of GDP spent in 2010, and equates to a rise of about £80 billion in today’s terms.

According to government projections, 11 million Britons will live to the age of 100. Economists have estimated that the international cost of ageing populations will be 10 times that resulting from the financial crisis.

Last week, the pensions minister, Steve Webb, warned that the UK must radically re-think the idea of retirement as life expectancy continues to lengthen.

Plans are in place to raise the state pension age to 66 and the default retirement age of 65 has already been abolished.

Last night, David Willetts, the universities minister, backed the OECD for setting out the “inevitable” burden Britain faces “as the baby boomers age”.

The OECD analysis, which will be presented in Paris this week, suggested that to pay for the care and pensions that an ageing population will need, adults will be forced to spend much longer working and taxes may have to rise.

According to the OECD’s figures, Britain’s projected bill for long-term care and support services – such as home help, adaptations to property, and residential accommodation – will almost double from 2.2% of GDP to 4.3% by 2050.

Of the 28 OECD countries included in the research, only Malta and Spain will be spending a higher proportion of national income on long-term care.

But the research on “intergenerational solidarity” warned that the rising bill for elderly care could “undermine the nexus of family relations between generations”.

The OECD report said: “Future generations may be less willing and able to pay continually rising taxes to support a growing share of economically inactive people.”

Countries where large numbers of older people rely on state pensions and care are more likely to regard the elderly as “a burden” on society, the research suggested.

In addition, the UK is particularly at risk as a result of high rates of family breakdown, with more than 12% of British children living in step families, compared with an OECD average of 8%, and more single parents.

Mr Whitehouse said smaller and more complex families meant there would be fewer people to provide “informal care” to frail relatives in future.

One key solution would be for older people to remain in work for longer and build up their own private pensions, he said.

“When people see that older people are doing things to help themselves they have a more positive attitude towards them than in countries where they are very reliant on the state and where people are retiring early,” he said.

The research also suggested, however, that many older people provide childcare for their grandchildren and give more of their time and money to younger people than they receive directly in return.

Those most likely to regard older people as “a burden” were the elderly themselves.

Mr Willetts, whose has written a book on the subject, The Pinch, will detail the government’s plans to ensure fairness between generations in a speech at the Social Market Foundation think tank.

He told The Telegraph that the OECD had set out some of the increased burdens are “inevitable” as the post-war “baby boom” generation ages.

“Any healthy society has an obligation to its older members as well as its younger members but we have got to be more flexible,” he said. “That’s why we are moving to raise the pension age.

“The contract between generations is in everyone’s interest. We have got an obligation to our kids to give them a good education and help them get a start on the housing ladder and build up pension savings. That increases the chance that they will then sustain us when baby boomers need domiciliary care and nursing care.

“There is an American bumper sticker which says, ‘Be nice to your kids, they choose your nursing home.’”

Stephen Burke, director of United for All Ages, a social enterprise working with councils and charities, said the growing bill for elderly care was “already causing tensions between generations”.

“The cuts in public spending are pitting the needs of older and disabled people against children, young people and families,” he said. “Using older people’s wealth, for example through a care duty on estates, would be a fairer way of paying for better care for our ageing population.”

From: http://www.telegraph.co.uk/OECD-huge-elderly-care-bill-threatens-family-ties