Dereliction of duty in an ageist society

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Abstract
The Royal Commission on Long Term Care submitted its report to parliament over a year ago.1 The recommendations have been widely supported, perhaps most notably by the parliamentary health select committee, which declared that “failure to act would be dereliction of duty” and again recently by the presidents of three royal colleges and of the British Geriatrics Society.2 Yet the government has still to respond to the principal majority recommendation that “the costs of care for those individuals who need it should be split between living costs, housing costs, and personal care. Personal care should be available after an assessment, according to need and paid for from general taxation: the rest should be subject to a co-payment according to means.” The royal commission was set up to examine the options for a sustainable system of funding long term care in the face of a widespread perception, particularly among older people, that the current system is unjust. With the apparently laudable aim of combining improved cost effectiveness with less care in institutions …