Better healthcare for all

It is clear that both of the main political parties are keen to maximise their offering to the UK's ten million elderly voters, for the obvious reason that they are more likely to vote than those of the middle aged or younger demographic.

However despite the high level of consensus between Labour and the Conservatives in their pledges to older people, there remain significant differences in their respective approaches.

Labour's key pledge is to repeal the Health and Social Care Act 2012; legislation which they argue will destroy the NHS by needlessly wasting resources due to compulsory competition laws. The Conservatives have pledged to cap the costs of residential social care from 2016 and to prioritise health care for the elderly.

Labour have stated that repealing the Health and Social Care Act will not involve a disruptive reorganisation of the NHS, rather they will work through the structures they inherit. What would their pledge involve?

Tinkering with the NHS

Labour have confirmed that they only intend to repeal part 3 of the Act, which deals with the promotion of markets and competition. Ed Miliband has pledged an end to the 'free market experiment' with the NHS.

Andy Burnham, the Shadow Secretary of State for Health, has promised to achieve 'full integration of health and social care', but how can this be achieved without large scale structural reform? How can the private companies who have won large long term contracts, particularly for community health services, be removed without huge upheaval? The promise of integration as an evolving, money-saving option does not seem to be backed up by any evidence.

The Conservatives on the other hand, would keep the changes made to the NHS by the Act, thereby continuing to reduce the state's role in the provision of healthcare services, within a framework which they believe will increase competitive market forces and responsiveness to local patient needs.

Within this framework the Conservatives have pledged to cap the cost of residential social care from April 2016 at £72,000, over the rest of a person's life after the age of 65. There are three important caveats. First, access to the system is rationed to people with high care needs; only when an individual is deemed to be eligible for care does their spending count towards the cap.

Second, even when an individual is deemed to be eligible, £230 of the weekly fee for a person living in a care home doesn't count towards the cap, as this money is earmarked for living costs including food, the room and heating.

Third, an individual's bill only racks up at the rate a council would pay for a place in the care home, but many care homes charge people who are self-funding up to twice as much as this. The result of these caveats is that, by the time an individual reaches the cap, they may have already paid significantly more than £72,000 for their care.

Guarantees for the most in need

The Conservatives have also promised that they will prioritise healthcare for the elderly, with a guarantee that everyone over 75 will get a same-day appointment with their GP if they need one.

Labour have said that they will guarantee appointments within 48 hours for everyone and on the same day for those who need it. While these promises are appealing, how they would be achieved in practice is unclear. It is well established that there is a chronic shortage of GPs in many parts of the country.

While it is encouraging that the main parties have realised the importance of addressing the funding shortfall for healthcare, both for the elderly and more generally, it seems that the proposed policies raise more questions than they answer.

As many voters are aware, the parties will simply not be able to keep the promises they are making now, which is why they risk losing the trust of the electorate. If a coalition is formed, it is even more likely that compromises will have to be made, and promises broken.

Helen Barnett is an associate in the private wealth team at Bircham Dyson Bell