In July 2011, Jersey's States Assembly unanimously approved the principle of a new Long-Term Care Scheme.

Not a single Member voted against it.

The proposal was presented as a landmark social reform designed to solve one of the Island's most difficult and emotionally charged problems: how to protect families from the devastating financial consequences of long-term care.

At the time, the case for change was compelling.

People were living longer. The number of Islanders requiring care was expected to increase significantly. Families often discovered, during moments of crisis, that they could face bills running into hundreds of thousands of pounds simply because a loved one required residential care.

The existing system was widely criticised as unfair.

Then Social Security Minister Ian Gorst argued that the burden should no longer fall solely on the unlucky few who required care. Instead, the risk would be shared across the wider community through a dedicated Long-Term Care Fund funded by compulsory contributions.

Few disagreed with the principle.

Fourteen years later, however, a review of the public record raises an important question:

Is the scheme operating today the same scheme that Islanders were originally told they were getting?

Why The Scheme Was Created

Before the Long-Term Care Scheme, homeowners who required residential care often found themselves excluded from financial support because of the value of their property.

Care costs could exceed £1,000 per week.

Families frequently discovered that a lifetime of saving and home ownership became a liability rather than a source of security.

The Long-Term Care Scheme was designed to change that.

The idea was simple.

Rather than leaving care costs to the individual, the cost would be shared across society through dedicated Long-Term Care contributions. Islanders would pay into a ring-fenced fund during their working lives and receive support if they later required care.

The scheme was built on three key principles:

Pooling the risk of care costs across the population. Protecting homeowners from losing everything because they required care. Supporting people to remain in their own homes for longer.

It was sold as a fairer, more compassionate approach to a growing social challenge.

Ian Gorst's Role

While many politicians, officials and scrutiny panels contributed to the development of the scheme, the public record shows that Ian Gorst played a central role in its creation.

As Minister for Social Security, he led the consultation process, published the Green Paper and White Paper proposals, brought the legislation to the Assembly and publicly promoted the scheme through island-wide engagement.

In a later States debate, Senator Gorst reminded Members that he had personally: "published those founding documents" and conducted "parochial roadshows" to build support for the legislation.

The Long-Term Care Scheme was not simply introduced during his time in office. He was one of its principal architects.

The Scheme Islanders Thought They Were Getting

One of the most significant protections discussed during the original debates concerned the family home.

In 2011, Ian Gorst proposed that up to £750,000 of the value of a person's main residence would be disregarded when assessing eligibility for support. He argued that people who had worked hard all their lives should not face the prospect of losing their home because they needed care.

For many Islanders, this was one of the most important elements of the proposal.

The message was clear.

The scheme would help protect ordinary homeowners from the catastrophic financial consequences of long-term care.

The Assembly unanimously approved the enabling legislation.

What Changed Between 2011 and 2013?

The story did not end with the 2011 vote.

The legislation approved by the States established the framework, but the detailed operating rules still had to be developed and approved.

When those regulations returned to the Assembly in 2013, significant changes had been made.

Most notably, the proposed property disregard had fallen from £750,000 to £419,000.

That represented a reduction of approximately 44 per cent.

At the same time, detailed provisions were introduced governing: Property-backed loans. Interest charges on those loans. Financial assessments. Asset recovery arrangements. The treatment of gifts made during the previous ten years.

These may have appeared to be technical changes.

In reality, they directly affect how much wealth a family can ultimately retain when a loved one enters long-term care.

The result is that there are arguably two Long-Term Care stories.

The first is the scheme Islanders were consulted on and encouraged to support. The second is the scheme that ultimately entered operation. The question is whether Islanders fully appreciated the difference.

The Cost of Care Since The Scheme Began

Supporters of the Long-Term Care Scheme can rightly point to the fact that it has provided support to thousands of Islanders who would otherwise have faced substantial care costs.

But another question deserves attention.

What has happened to the cost of care itself?

Today, standard residential care costs range from approximately £1,025 per week to almost £2,000 per week depending on care needs.

For those requiring high-level residential care, annual costs can exceed £100,000.

Even more striking is the pace of increase.

Between 2022 and 2026, standard residential care rates increased by approximately one third.

Between 2022 and 2026 weekly care costs have gone up 33% to 34%

Level 1 went from £769 in 2022 to £1,025 in 2026 an increase of 33%.

Level 2 went from £983 in 2022 to £1,312 in 2026 an increase of 33%.

Level 3 went from £1,261 in 2022 to £1,684 in 2026 an increase of 34%.

Level 4 went from £1,492 in 2022 to £1,994 in 2026 an increase of 34%.

At the same time, spending through the Long-Term Care Fund has increased substantially.

The financial pressure on the scheme continues to grow.

Some of this increase is entirely predictable.

Jersey's population is ageing. More Islanders require care. Staffing costs have increased. Energy costs have increased. Regulation has increased. Demand has increased.

Yet the direction of travel remains clear.

The cost of care is rising rapidly.

A Question Nobody Seems To Be Asking

There is currently no evidence that care providers have deliberately increased prices because Long-Term Care funding exists.

Nor would it be fair to suggest that care providers are not facing genuine cost pressures.

However, when government funding enters any market, an obvious policy question follows: What mechanisms exist to ensure costs remain sustainable? Government already intervenes in parts of the care market. Standard pricing has been introduced for elements of home care. Yet residential care pricing remains largely market-driven. As a result, Islanders find themselves in an unusual position.

Every time care costs rise, the debate focuses on how to raise additional funding.

Much less attention appears to be given to whether those underlying costs can be controlled, challenged or better understood.

The public conversation is overwhelmingly focused on collecting more money.

It is far less focused on reducing the amount of money required.

The Next Increase

The debate is about to enter a new phase.

Government projections indicate increasing pressure on the Long-Term Care Fund and discussion has already begun around the possibility of a further increase in Long-Term Care contributions from 2027.

The argument is familiar. People are living longer. More people require care. Care is becoming more expensive. Therefore Islanders must contribute more.

But after fourteen years, some Islanders may reasonably ask a different question.

Why does every solution appear to begin with higher taxation? The Long-Term Care contribution started at 0.5%. It increased to 1%. It then increased to 1.5%. Now discussion is turning towards another increase.

Meanwhile: Care costs continue to rise. Property values continue to rise. The protection offered by the scheme has not kept pace. Government expenditure continues to rise. The fund itself remains under pressure. The burden has not disappeared. It has simply shifted.

The Question For Today's Assembly

The original problem that inspired the Long-Term Care Scheme was real. Without intervention, many Islanders would still face catastrophic care costs. But support for the principle of the scheme should not prevent scrutiny of its operation.

The real question is no longer whether the scheme should exist.

The real question is whether it is still delivering the protection Islanders were promised.

Because before asking taxpayers to contribute even more, many Islanders may reasonably expect Government to demonstrate that every effort has been made to understand and control the costs driving those increases.

The Long-Term Care Scheme was created because politicians recognised it was unfair to leave families exposed to unlimited care costs.

Fourteen years later, Islanders may ask whether it is equally unfair for taxpayers to become the automatic solution whenever those costs continue to rise.

The challenge facing the next Assembly is not simply whether contributions should increase again.

It is whether Jersey has done enough to examine the cost of care itself.

Because every pound added to the Long-Term Care contribution is a pound taken from working Islanders.

And before asking the public to pay more, Government should be able to show that it has done everything possible to ensure those costs are necessary, sustainable and justified.

That conversation has never been more important than it is today.