The government has seriously underestimated the costs involved
in providing free nursing care to elderly people in nursing homes
according to the Registered Nursing Home Association (RNHA),
writes Gideon Burrows.
A survey by the RNHA shows that some very dependent patients’
nursing costs could be as high as £420 a week. But the maximum
payment under the new banding scheme would be £110 a week.
Unison has also objected to the plans for funding, describing
them as “grossly inadequate”, and calling for the banding system to
be rejected. The union has written to health minister Jacqui
Its deputy general secretary Keith Sonnet said: “Provision
should be based on need and the NHS should meet the full cost of an
individual’s nursing and health care with no artificial cap
on that provision. As it stands nurses may be put in a difficult
position of having to determine how much free nursing care a
patient will receive.”
The union has also criticised the prospect of a two-tier system
of long-term care in the UK, which would see older people in
Scotland entitled to free provision of services while the rest of
the UK would have to pay. Sonnet said he could envisage a scenario
where “elderly people slip over the border to take advantage of
free nursing care they so desperately need”.
Concerns have also been raised by The Coalition for Quality in
Care which has criticised what it says is a too-narrow definition
of free nursing, which excludes the work of care assistants who
perform nursing tasks.
Another worry is that the guidance talks about nursing homes and
dual registered homes rather than care homes which, according to
the coalition, ignores the changes to regulations to be introduced
under the Care Standards Act 2000.
Meanwhile the charity Counsel and Care has warned that cost
considerations will be placed above older people’s choice when it
comes to selecting a nursing home.
Spokesperson Paul Martindale said: “Many local authorities
already ignore department of health directions on choice of
accommodation, and restrict older people in homes which offer the
cheapest fees or with whom the authority has block booked
He urged the government to make sure that older people’s rights
to choice and control were promoted in the new arrangements.
But the department of health said: “The provision of free
nursing care will not affect most older people’s choice of
homes, and the majority of placements will continue to be made by
local councils. Only in cases where the homes are unable to match
nursing care needs of a person will choice be reduced.”
Over 130 organisations have contributed to a four-week
consultation exercise on free nursing care, and their responses are
now being analysed.