Today’s article is a response to the recent announcement that, after September 2012, most elderly people in care in England will no longer have proper financial redress for wrongly charged care fees.
I remember it vividly. Sitting at the bottom of the stairs just after Christmas 2007, I opened the letter. As I read it, I began to sob. They were hard and heavy tears. I had been fighting for this letter for so long and now it finally confirmed that the NHS had acted illegally in charging my mother for care.
It also confirmed that the NHS would be issuing a refund of care fees and providing ongoing funding to cover all her care needs. It had been a ghastly battle – and at that point I was also in the middle of the same battle for my father.
20 years earlier they had both been diagnosed with Parkinson’s disease. They both subsequently developed dementia and other serious health conditions, they both went into a care home on the same day in 2005, and they both died within a few weeks of each other at the end of 2009.
My battle with the NHS for both of them took over three and a half years and left me utterly exhausted. I eventually succeeded in forcing the NHS to pay back over £105,000 in care fees and provide fully-funded Continuing Care for my parents right up until they died.
NHS funding for full-time care is called NHS Continuing Healthcare and it covers 100% of the costs of being in a care home or receiving full-time care at home for people whose needs are primarily health needs.
I’m not talking here about the current crisis in social care, which is bad enough in itself. This is about NHS care – the healthcare that is available to all of us because we live in the UK. Except, it seems, if you’re old.
In the UK healthcare/nursing care is free at the point of use. It is not based on ability to pay, and yet elderly people in full-time care are routinely told the opposite: that even though they may have health needs, they have to pay for their care.
It is one of the biggest scandals in health service provision, accounting for billions in lost personal assets, and it has been going on for years. But the most horrifying thing of all is that it is not just a small hole in the care system; instead, it is a massive unfairness that seems to be actively perpetuated and supported by the State. Successive governments have done little to stop it..
I believe this maladministration has and will directly affect every family in the UK, and it will continue unless the voices raised in protest continue to grow in strength and volume.
Breaking the law as routine
The whole Continuing Care application, appeal and review process is controlled by the very people who hold the purse strings, and that simply cannot be right. In my parents’ case, and in the case of tens of thousands of other families, the NHS seems to break the rules as routine – as a way of making people fight for the care they’re legally entitled to and most probably in the hope that those families will simply give up and go away.
Generally speaking, in the UK, no matter how old you are, if you need health care or nursing care, you do not have to pay for it.
The National Health Service Act 1946 outlined this clearly, as did the 2006 National Health Services Act. This has not changed. Indeed, the coalition government was at pains to point out that the new Health and Social Care Act 2012 also preserves it.
The law states that the Secretary of State has a statutory duty to promote a comprehensive health service, and the services provided must be free of charge. If the essence of the law is not being followed – to promote and provide health services, the government and the Secretary of State are answerable.
Despite this, a complex web of financially-motivated Continuing Care assessments and eligibility criteria has been fabricated for elderly people who need full time care – and this has wrongly been in place for many years. This assessment framework does not override case law, and yet NHS ‘assessors’ and decision making panels seem to take on the role of judge and jury, when in fact the principle of healthcare free at the point of use has never changed.
Most of us have no reason to understand the ins and outs of the care funding system – until that need is thrust upon us by an elderly relative needing care. Most of us also assume we can trust the health and social care authorities to tell us the truth about paying for care. Sadly, what we often seem to be told is far from the truth. It means when an elderly person goes into a care home, families don’t realise that the first priority is NHS funding – not questions about their money, property and savings.
This ‘oversight’ of the part of the authorities means that hundreds of thousands of elderly people have been illegally railroaded into selling their homes and everything they own to pay for care that should have been provided by the NHS – just as it is for other people in the UK. It is age discrimination on a massive scale. The press, too, in articles about care fees, rarely mention NHS Continuing Care funding, which further perpetuates the myth that when you grow old you have to pay for care.