A group of organisations has called for a public debate on the balance between state and personal funding of health and social care.
Social care leaders, health practitioners and charities made the call in co-ordinated responses to the government’s consultation on a national framework for NHS continuing care, which closed last week. They also criticised some of the Department of Health’s proposals (see Criticisms of DH continuing care proposals).
The government has so far resisted such a debate because it might call into question the NHS’s founding principle – that health care should be free at the point of delivery – and could herald large increases in state funding for social care.
But in their responses to the consultation, Age Concern, the Alzheimer’s Society, Help the Aged and the Royal College of Nursing said continuing care – where the NHS fully funds long-term care for those with severe needs – could not be considered in isolation.
The Association of Directors of Social Services was expected to convey a similar message in its response, which was not available as Community Care went to press.
NHS bodies have been criticised for rationing continuing care on cost grounds, forcing service users to receive means-tested help from councils.
In its response, Age Concern questioned the purpose of “having to untangle what is health and what is social care, purely to establish whether care is free or means-tested”, saying it detracted from providing the right level of care.
It said a funding debate was imperative because of the increasing numbers of older people, their hostility to means-testing, the increasing emphasis on integration between health and social care, and the confusion caused by the current system.
Criticisms of DH continuing care proposals
● They set the bar for eligibility higher than the Coughlan judgment, the andmark ruling on continuing care (The Law Society).
● The DH should make all those assessed as needing nursing home care eigible for continuing care (The Law Society, the RCN).
● The proposals allow for too much local discretion, perpetuating the current postcode lottery” of different criteria in different areas (The Alzheimer’s Society, the RCN, Age Concern, The Law Society).
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