From Professor Michael Lye

Sir: Nicholas Timmins's report "Value of home should fund care in old age" and your leading article "Why didn't you save more, Grandpa?" (30 January) were unduly pessimistic in painting a picture of increasing and inevitable decline in our old age.

Old people become dependent and require nursing home support not because they are old but because they are ill. Our own everyday experience recognises that not all old people are helpless. Indeed, the majority are fit and well and living in their own homes. It is estimated that fewer than 5 per cent of old people in the UK require institutional care and this proportion is unlikely to change though, with increasing numbers of older people in the population, the absolute numbers in need of care will increase in the next century.

Your solution of public or private insurance for long-term care in old age ignores an alternative approach. Geriatric medical services oriented to the specific problems of old age are beneficial but, in truth, all doctors require experience and training in the management of disease in elderly patients. They should obtain this experience as undergraduates and it should continue throughout their training.

The role of strong academic departments of geriatric medicine in each medical school is particularly important in this regard. Throwing money, in whatever form, at the problem is no solution - the problem itself requires attention.

Yours faithfully,

Michael Lye

Head of Department

Geriatric Medicine

The University of Liverpool

Liverpool

31 January