A blueprint for how the Elderly should be cared for is the subject of a review launched today.

The King's Fund,a health think tank, has commissioned Sir Derek Wanless to look at how the demand and supply of care for the over 65’s will change.

The review follows Sir Derek's two previous reports for the government on public health and healthcare spending.

This study is likely to resurrect the debate about free personal care for the elderly – currently provided in Scotland but not England or Wales.

Some 486,000 people are looked after in independent and local authority-run care homes, a fall of up to 9,600 in the last year. Care home places peaked in 1996 but have dropped by 89,000 since then as more and more people are looked after in their own homes.

The review is due to be published in the Spring of 2006, and is to address the question of how care is paid for.

21 st Century Care

Sir Derek said: "There is a great need for a review of the challenges and demands facing social care, and the resources that will be needed to deliver social care fit for the 21st century.

"Demand and expectations for social care services will increase and this growth may well outstrip growth in spending.

"Therefore, thinking about social care policy needs to be integrated with thinking about health care policy."

According to his 2002 report health spending would need to double over the next 20 years to provide a good quality service. More recently Sir Derek called for more effort in preventing illness, rather than just treating it, pointing out it was the responsibility of government, schools and individuals to improve public health.

Major Impact

King's Fund chief executive Niall Dickson added: "It remains one of the big unanswered policy questions.

"We believe this review should have a major impact on the way care and support for older people is delivered in this country."

Meanwhile, Health Secretary John Reid has published a paper, Limits of the Market, Constraints of the State, stating that patient choice is not a right-wing value.

In the report, he has written that choice has been restricted to the wealthy in the past, but the government’s view is that choice should be available to all regardless of means.

Health Minister Stephen Ladyman said he welcomed all "contributions to the current debate over the future of social care".

"Meeting the care and support needs of a wide and varied population is complex.

"We have to find better ways to deliver care and to give people more choice and control over the care they receive.

"The government is currently carrying out a review of efficiency in social care services and the King's Fund study will complement this work."