The Sutherland Report
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  The Sutherland Report
With Respect to Old Age: Long Term Care - Rights and Responsibilities

A Report by The Royal Commission on Long Term Care
Chairman: Professor Sir Stewart Sutherland
Presented to Parliament by Command of Her Majesty
March 1999

This is just a brief extract from the report - the complete report can be viewed at Official documents web site.


The Commission took the view that old age should not be seen as a problem, but a time of life with fulfilments of its own. To provide security in old age and proper care for those that need it our main recommendations are that:

  • The costs of long-term care should be split between living costs, housing costs and personal care. Personal care should be available after assessment, according to need and paid for from general taxation: the rest should be subject to a co-payment according to means. 
  • The Government should establish a National Care Commission to monitor trends, including demography and spending, ensure transparency and accountability in the system, represent the interests of consumers, and set national benchmarks, now and in the future. 

The Commission sought to recommend a way of paying for long-term care which brings improvements in the short term and which is affordable and sustainable. It is a complex issue and none of the options are easy. Three key principles informed the approach we have taken:

  • Responsibility for provision now and in the future should be shared between the state and individuals - the aim is to find a division affordable for both and one which people can understand and accept as fair and logical
  • Any new system of state support should be fair and equitable
  • Any new system of state support should be transparent in respect of the resources underpinning it, the entitlement of individuals under it and what it leaves to personal responsibility.

The Commission conclude that doing nothing with respect to the current system is not an option. It is too complex and provides no clarity as to what people can expect. It too often causes people to move into residential care when this might not be the best outcome. Help is available to the poorest but the system leads to the impoverishment of people with moderate assets before they get any help. There is a degree of fear about the system which is of concern in a modern welfare state. It is riddled with inefficiencies. 
The time has come for it to be properly modernised.