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As an independent inquiry reveals that thousands of elderly people have been wrongly paying for medical care, just what are the implications for the future of long-term personal care in the UK? Gary Flood reports
An age-old scandal?
Elderly people have been wrongly charged for medical care they should
have been entitled to for free.
The independent Health Service Ombundsman, Ann Abraham, has upheld the
complaints of four patients forced to pay for medical attention in their
nursing homes, contrary to Department of Health guidelines.
But the problem is more widespread than these individual cases.
The rules are in her words being ‘misinterpreted and misapplied
by some health authorities and trusts, leading to hardship and injustice
for some individuals’.
There may be thousands of people around England and Wales who’ve
been asked to find between £400 and £600 a week to pay for
this kind of vital care.
The news has once again brought into focus the issue of how to fund care
for our ageing population.
‘The government’s current policies in relation to long-term
care are complex, open to misinterpretation and ultimately unfair to vulnerable
members of our society,’ warns Christine Durance, UNISON policy officer.
UNISON has been focusing attention on this issue with its long-running
Right to Care campaign.
This calls for all nursing and personal care being available on the basis
of need, free at the point of use and funded from local taxation.
The specific issue of care payment pre-dates Labour coming to power in
1997 - during the previous Tory administration stories abounded of elderly
people forced into selling their homes to pay for their care when they
went into the UK’s 20,000-plus nursing or residential homes. (Those
in hospitals have always been cared for for free.)
The rules said anyone with assets of £16,000 and up had to pay.
Labour promised a Royal Commission on the situation, which delivered
its 
report in March 1999.
The Sutherland Report, named after its chairman, recommended such care
should be paid for out of general taxation and be free at the point of
delivery - a proposal that would cost the Exchequer around £1bn
a year.
But the government sat on the report for a year and faced criticism that
it was unwilling to face up to the called-for expenditure.
Government eventually agreed to fund 100% of nursing care, but not to cover what it calls ‘personal’ care.
However, the Scottish Executive decided to go against Westminster and
make both nursing and personal care free last year.
Another factor is the poor state of the private nursing home industry,
in which many UNISON members work.
It says local authorities are not offering economically viable rates
for the care home places they support.
The industry claims that figure is now around 71p an hour - far too low
to offer an adequate basis for better care.
Some of the smaller care homes say they’re being forced out of business
as a result. This might result in local or family-run homes being absorbed
by larger, more impersonal chains.
At the very least some home owners are evicting their council patients,
claiming their care can't be provided at the low levels being offered.
In 1999 some 800 such homes closed, losing 15,000 beds.
Meanwhile, according to the Tory opposition, 160,000 elderly people sold
their homes in the first four years of Labour rule to pay for their care.
‘The government needs to take full financial responsibility for
the care of the elderly whether at home, in hospital or residential and
nursing care and there should be a consistency of provision and equitable
access to care throughout the UK,’ says UNISON’s Durance.
As three million senior citizens live in such places - a figure set to rise with an ageing population - the issue doesn’t look like going away any time soon.
Contact the article's author Gary Flood
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