Among the press reports of Gordon Brown’s speech to the Labour Party conference yesterday, are the signs that the government is close to the ‘new settlement’ on social care for older people (and presumably other long-term conditions, or are they not bothering with disabled people etc?). This will mean some kind of clarity about how much local authoriities and the public will pay for care homes and home care.

What consequences will this have for NHS continuing care? This is an interlocking system, which provides more generous funding than local authority community care, but you cannot make a contribution to improve your care by paying a bit more for a home or a package of care that you actually want, as opposed to the grim places some PCTs make their patients live in. This is exactly the opposite of the policy with community care, where the patient must make a contribution if the means test says they can afford it.

Another Gordon announcement is relevant here: cancer patients (is it only them because of the emotional but irrational priority given to cancer as a dread disease?) are going to be allowed to top up their drugs, but still get NHS care if NICE will not agree that some new drug is cost effective. This is exactly the same rule that prevents family top-ups to care home fees, so if it’s going to be changed because of the durgs, it cannot be long before patients and families are allowed to top-up the continuing care payment for their care home. Although this may be a false assumption in view of the fact that continuing and community care policies are so riven with inconsistencies.