Britain can expect a substantial - possibly four-fold - increase in spending on long-term care for older people by the middle of the century as the number of people living into their late 80s and beyond increases and real care costs rise, according to new projections based on the latest official population projections.

The projections, prepared for the Joseph Rowntree Foundation, suggest that care spending would need to rise by 315 per cent in real terms between 2000 and 2051 to meet demographic pressures and rising costs, assuming that dependency rates, patterns of care and current funding arrangements remain unchanged.

Government Response: Department of Health

A Department of Health spokesman said: "By 2007/2008, the health and social care budget is set to rise to more than £90bn to take into account the rise in the number of older people and the need to more services.

“The report is based on an assumption that rising dependency rates will result in increased costs.

"We know baby boomers are much less likely than previous generations to choose or accept that moving to a care home is the only way they can be cared for as they become older and more frail.

"We are developing and implementing policy that will enable people to make wider choices about how they are cared for in the future, for example, through direct payments, adult placements and extra care housing."

Party Response: Conservative

Simon Burns shadow health spokesman said: "The governments handling of long term care is a tragedy of errors. Care homes and beds are being lost at record rates.

"What we need is a long hard look at the way forward to ensure dignity in old age for some of the most vulnerable in our society."

Stakeholder Response: Joseph Rowntree Foundation

Lord Best, director of Joseph Rowntree Foundation, said: "It is seven years since the Joseph Rowntree Foundation’s Inquiry into Paying for Long-term Care highlighted the implications for care services as life expectancy increases and those who were born during the post-war ‘baby-boom’ reach old age.

"These new projections show that the major problems our inquiry anticipated as demand for nursing, residential and home care increases have intensified.

"The potential for a four-fold increase in spending identified by this report should make politicians and policy makers stop and think carefully.

"We all need to consider what changes could be implemented now if we are to ensure that people now in their 30s, 40s and 50s can be sure of receiving a high standard of care when they need it in old age. It is time to re-open the debate."

Stakeholder Response: Help the Aged

Mervyn Kohler, Help the Aged's head of public affairs said:"Despite knowing what was happening on the demographic front for the last forty years, we have made a hash of getting to where we are today with the provision of care for older people.

"This research shows how much we have got to do over the next forty years.

"We must be imaginitive and innovative.   We need to find appropriate roles for new technology, and new community initiatives to offer support to older people living alone.

"We will need residential and nursing care homes - they may be the only safe way to care for people with severe dementia, of which there could be many more as the population ages.

"But if we found ways to keep people living independently in their own homes for even six months longer, it could make a big difference to health care costs.

"We need to plan on a local basis. There must be a range of flexible services available adequately in every community.

"It would be quite pointless if all the care homes were concentrated in one part of the country."

Stakeholder Response: Counsel and Care

Martin Green, chief executive of Counsel and Care said: "The Rowntree Report clearly shows that there is going to be an increase in both the need for and cost of care. In response to these finding, the government need to take immediate action and plan for the future. If we respond and plan now we can stop the issue reaching a crisis point later. This report clearly shows that if we under the sector now we will all pay a heavy price in the future.”