Huge bill for care payment errors

The Department of Health has allocated about £300m to
compensate people who have been wrongly made to pay for their
long-term care.

The figure – which the DoH has refused to confirm – illustrates the
massive implications of the health service ombudsman’s decision on
four test cases earlier this year (news, page 10, 27 February).

The money is being allocated to strategic health authorities and
primary care trusts in their overall budgets. Thames Valley SHA has
received a £7.96m one-off payment for expected claims, while
Birmingham has received £3.25m.

Dr Evan Harris, Liberal Democrat shadow health secretary, said he
had been told that the national total was “in the region of
£300m”.

A DoH spokesperson confirmed that money had been made available to
pay for “appropriate recompense” in cases which were proved to be
valid, but that it was not yet possible to estimate the numbers
entitled or the level of funding.

Since health ombudsman Ann Abraham reported in February that four
former health authorities had wrongly made patients with long-term
conditions pay for their own care she has received 2,694 written
complaints from people who believe they are in similar positions.
These have been forwarded onto strategic health authorities.

As all 28 strategic health authorities and hundreds of primary care
trusts have also been receiving claims for compensation directly
since the report was published, the total number of complaints is
likely to be much higher. In Dorset alone, 350 claims have been
made, although it estimates a “substantial majority of these” will
not qualify for review under its new criteria.

Following the report, local eligibility criteria on continuing care
are being updated where necessary and will be applied
retrospectively back to 1996. Staff are also being trained in how
to interpret the criteria.

PCTs have spent the past few months trawling through records to
estimate the amount of extra funding needed to cover expected
claims.

Fresh claims over aftercare charges

Social services authorities could be faced with compensation bills
worth millions of pounds from mental health clients who have been
incorrectly charged for their aftercare following a report from
local government ombudsmen.

The report states that a significant number of councils have broken
the law by incorrectly charging mental health sufferers who have
been discharged from compulsory detention in hospital for aftercare
services, particularly residential accommodation.

The guidance comes after a clarification of the law around
aftercare in 1999 resulted in a number of complaints. Evidence
given in that case suggested that around half of social services
authorities incorrectly charged for accommodation and councils
argued that not charging would cost them more than £50m.

The ombudsmen have called for all social services authorities to
identify those who have been improperly charged or deprived of
financial assistance and reimburse them. They add that no cut-off
date should be used when calculating repayments and that interest
should be added.

Other parts of the guidance state that councils should not carry
out retrospective assessments which aim to classify people as
ineligible for free services and call for any such decisions to be
reviewed.

Gil Hitchon, chief executive of mental health charity Maca, said it
was important that the payments were not to the detriment of
cash-strapped mental health services, and called on the government
to provide specific extra funding.