Thousands seek to challenge long-term care decisions

Almost 2,500 people have contacted the health service Ombudsman
following her report criticising four health authorities for
failing to pay for continuing care in nursing homes,
writes Craig Kenny.

In February, the Ombudsman Ann Abraham instructed the four
authorities to identify any other patients who may have been
wrongly made to pay for long-term care, and also invited
patient’s relatives to contact her for information on how to
proceed.

Ms Abraham’s office has since had 2,481 inquiries from
relatives seeking to challenge funding decisions, and has forwarded
300 cases to Strategic Health Authorities.

And in her latest report, the Ombudsman criticised a fifth SHA for
its “over restrictive” eligibility criteria for long-term care, and
ordered them to pay £20,000 in compensation.

The case concerned 82-year-old Marjorie Baxter, who has Alzheimers
but was refused funding for care by Suffolk Health Authority.

Although she was first assessed as eligible, a second assessment
for a placement closer to her husband’s home reached the
opposite conclusion. Suffolk were criticised by the Ombudsman for
having two different assessment procedures in different parts of
the county.

Moreover, the criteria were “over restrictive” in the light of the
Coughlan case in 1999, which prompted new Department of Health
guidance on continuing care.

Mrs Baxter’s son Andrew Baxter said that nursing home fees
over five years had already cost his elderly father £100,000.
“The health authority have acted in a deplorable manner and given
us short shrift at our every attempt to challenge their position,”
he said.

“The system is a complete lottery – and we drew the
shortest straw.”

The Alzheimers Society said that thousands were probably in a
similar position, but relatives were confused by the jargon. “Most
people have no idea of the difference between NHS continuing care
and free nursing care,” said a spokesperson.

“It is amazing that people in an advanced state of dementia are
still paying because they are told their care is personal and not
healthcare. It’s a big fight to get acknowledgement that
dementia is a health problem, not just a part of ageing.”

Four SHAs – Dorset, Wigan and Bolton, Berkshire and
Birmingham – have now reviewed all their continuing care
funding decisions, and reported them to the DoH last week. But the
DoH refused to say if the information would be made public, or what
action would be taken.  “We are considering the next steps,
there’s no time frame,” said a spokesperson.