Features
Care for the elderly is free in Scotland – but not in the rest of the UK. Tony Braisby reports on the financial and emotional struggle facing many people
Witholding personal care
Barbara Pointon’s husband Michael is ill with advanced Alzheimer’s disease. He needs constant care and nursing: he can no longer talk, feed or dress himself and needs help with drinking and washing.
Both Michael and Barbara were music lecturers. He was medically retired in 1991after being diagnosed with Alzheimer’s at the age of 51. Barbara gave up work early eight years ago to help look after her husband. With the aid of a carer, she provides seven and a half hours of hands-on, four-handed care seven days a week.
And although, as she says, Michael is “an NHS patient being nursed at home”, the NHS does not pay for her husband’s care.
The basic care he receives keeps him as well as he is, while in the last stages of the illness, with severe physical and mental disabilities.
But in three NHS assessments of his needs, the local health authority has judged that the care Malcolm receives is personal or social care, not health care: so it does not pay.
The Pointons’ story is typical of many elderly people in England, Wales and Northern Ireland who need care, whether in nursing homes – where Malcolm stayed for nearly two years – or at home.
Since October 2001, following the report of the royal commission on long-term care of the elderly, so-called nursing care is provided free, but supposed personal or social care is means-tested and charged to those deemed able to pay for it.
But the commission had called for nursing and personal care to be available free at the point of use, and paid for by general taxation.
Since 1 July, that has been the situation in Scotland. But the rest of the UK maintains the distinction between nursing and personal care – which Barbara Pointon herself calls “perverse and unworkable in practice”.
Care, she says “needs to be holistic: health care is not just about
drugs and drains”.
And that is a point UNISON backs through the Right to Care campaign for
free long-term care of the elderly, supported by the union and other organisations.
Barbara told her story at a Right to Care seminar organised by UNISON, and chaired by Guardian columnist Polly Toynbee, where general secretary Dave Prentis added his support.
“One of our major objections to the government’s care policy is the artificial and narrow definition of nursing care, which only covers the time spent by a registered nurse and not the care given by nursing assistants.
“The result of this is that nursing care does not apply to many people with Alzheimer’s disease or other forms of dementia. The experiences of Barbara and her husband Malcolm poignantly illustrate how this policy affects real people.”
UNISON, he added, has a double stake in the campaign. It is union members – whether nurses, nursing assistants or care assistants – who provide care and they want to be able to provide quality care to those in need.
But the union also believes that its members and their families, in common with the rest of the British public, deserve to receive care when they need it and that this should be on the basis of an assessment of their needs, without worrying about payment – “a test of a mature and civilised society”.
The Right to Care campaign’s demands are simple:
• The artificial distinction between ‘nursing’ and ‘personal’ care should be ended;
• Means testing of ‘personal’ should stop – it is unacceptable to charge older or disabled people for essential personal care which would be provided free in a hospital setting;
• The recommendations of the royal commission of long term care should be implemented in full;
• In particular, this must mean free personal and nursing care available as of need, funded from general taxation, to everyone, wherever in the UK they live.As royal commissioner Robin Wendt told the seminar, this is in line with existing rights to public service in areas such as health, education, roads or the police.
And it is affordable: the commission estimated the cost of providing security in old age by supplying care to those who need it at £1 billion pounds – just 0.1% of national income.
And the public agrees. Not only did free care for the elderly come top of the concerns in the recent BBC NHS day phone-in, but a MORI poll showed 84% of the public support free personal care – this figure dipped only 3% to 81% after a cost of £1bn was placed on it.
As NHS worker and UNISON executive member Myfanwy Manning told the symposium: “We will fight on this campaign, and we intend to win it.”
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The situation in Scotland From 1 July 2002, for people aged 65 and over: • All personal care charges for those cared for in their own homes have been abolished; • Those needing nursing care – at home or in a care home – will receive it free of charge; • Those in residential accommodation who pay toward the cost of their care will receive a “free personal care” payment of £145 per week; • Those in a nursing home will receive a “free
personal and nursing care” payment of £210 a week.
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