Behind the headlines

People are being unfairly forced to pay for long-term care, the
health service ombudsman has decided.

Ann Abraham’s recommendation that they should be
compensated could be costly to the NHS since she not only upheld
complaints concerning four older people that they were wrongly
charged for services, but she also said the four health authorities
should find out whether other people had been placed in the same
circumstances. “Significant numbers of people and sums of money are
likely to be involved,” Abraham said. She investigated Dorset,
Wigan and Bolton, Berkshire and Birmingham health authorities after
complaints about eligibility criteria for NHS funding of long-term
care of older and disabled people. Department of Health guidance on
the funding of long-term care had been misinterpreted in some
quarters, she said, and should be clarified. Paul Burstow, the
Liberal Democrat spokesperson on older people, said: “Tens of
thousands of elderly people have been illegally forced to pay for
long-term care that should have been free. It could cost taxpayers
hundreds of millions of pounds.”

Martin Green, chief executive, Counsel and Care for the
“The ombudsman’s decision on the funding of long-term care
highlights the disarray that exists in government policy on the
issue and the way in which the NHS is trying to shift the costs of
care on to the individual. This situation is also happening in the
residential care sector, where many local authorities are seriously
underfunding care placements. Long-term care requires long-term
planning and resourcing and the government needs to place it much
higher up the priority list, redirecting some of the billions that
seem to be available in the budget for other things.”

Frampton, national chairperson, Care
Leavers Association
“Of course, the ombudsman’s decision is right to flag up
the denial of health service users’ rights. However, one wonders
how may of those older people still alive will receive
reimbursement by one government department and have it immediately
taken off them by another. It is one more area where government is
failing to protect the needy and falling into the trap of the
two-tier NHS.”

Bob Hudson, principal research fellow, Nuffield Institute
for Health, University of Leeds
“Funding and responsibility for long-term care constitutes
one of the most abject post-war social policies. For decades the
NHS stealthily divested itself of its responsibilities and quietly
passed the bill to social services. Ann Abraham’s predecessor blew
the whistle on that in 1994, resulting in centrally issued
continuing care guidelines, yet here we are again. This is all
about money. The only solution is to follow the lead of the Scots
and make long-term health and social care free at the point of

Bill Badham, development officer, National Youth
“Squabbles between health and social services about who
(if anyone) in the state system pays what for whom exacerbate the
running battles between the two sectors and, more importantly,
confuse and cause more anxiety to people often already confused and
anxious. In a caring society, our focus should be on the person
needing care and the definition of that care should extend to their
and their family’s mental well-being and sense of security. Clear
and unambiguous criteria, applied fairly and uniformly across the
country and properly communicated are essential.”

Felicity Collier, chief executive, Baaf Adoption and
“News of this ruling will cause concern but also give hope
to thousands of people, including the most powerless in our
society. The issues must be resolved quickly so that much clearer
guidance is available to health authorities. Despite the huge
potential costs, it is surely time for older and disabled people to
have the same rights to state-funded nursing care as the rest of
us. How reassuring that there are ombudsmen to hold us to

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