MPs propose integrated system to ensure funding for long-term care

The next government has been urged by MPs to create a fully
integrated health and social care system to guarantee long-term
care funding is fair.

They say the problems in the NHS continuing care system stem from
an “artificial” distinction between free health and means-tested
social care.

Under the existing system, free NHS-funded care is available to
those with a primary health need. But for other people in long-term
care, the health service meets the nursing costs only. Personal
care and accommodation are means-tested.

The MPs say this has encouraged the NHS to pass on the care costs
to social services and users through restrictive local criteria and
inadequate assessments for continuing care.

The report in which the comments are made was published by the
Labour-dominated health select committee. It stops short of
endorsing the Liberal Democrats’ policy of free personal care, but
it strongly suggests this as a way forward, alongside an integrated
health and social care system.

Although Labour has rejected the policy on cost grounds, the report
says it would create savings by removing the costs of “policing the
divide between health and social care”.

However, the committee says significant reforms can be made within
the existing continuing care system.

After previous reports by the health ombudsman, it calls for
national criteria for continuing care to end the postcode lottery
of strategic health authorities setting their own.

Although the government has committed itself to a “national
framework”, community care minister Stephen Ladyman has admitted
this may not involve national criteria.

The committee also calls for the integration of continuing care and
the registered nursing care contribution (RNCC), which covers NHS
payments for nursing care in care homes.

It says criteria for high band RNCC and continuing care are almost
identical. In some areas people are given the cheaper RNCC, without
being assessed for continuing care, contrary to guidance.

Older people’s groups welcomed the report.

Help the Aged policy manager Jonathan Ellis said: “We hope that
whatever government is elected on 5 May will implement these
recommendations as a matter of urgency.”

  • The report is available from

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