9:00am Saturday 28th July 2007
People in some parts of England are 160 times less likely to get free nursing home care or regular visits from a carer than others. Campaigners say this is because of an unfair National Health Service postcode lottery'.
Age Concern discovered from government figures that, as at March 31, 2007, Derby City Primary Care Trust was giving just seven people continuing care - that's 0.26 people per 10,000. This compares to Harrow Primary Care Trust with 826 people - 41.75 per 10,000 and 160 times higher than Derby. This is despite Harrow having 75,000 fewer people and a younger population.
"These new figures beggar belief," says Gordon Lishman, director general of Age Concern. "Individuals face a postcode lottery in getting NHS continuing care. There can be no justification for such huge variations in access to care."
Currently, it is up to staff in local health authorities to interpret government criteria to determine who is eligible for free health care in their area. It means people with identical needs often receive different decisions based purely on where they live, and an estimated 60,000 people are missing out.
There is an opportunity for change. From October 1, 2007 the Government introduces a new system which aims to make care decisions fairer, faster and easier to understand. It is expected to raise the numbers of people receiving care by 7,000 at a cost of £220m.
"It will not solve all the problems at once," says care services minister Ivan Lewis. "But over time we expect there to be a real improvement that will lead to fair and consistent access to NHS funding across England, irrespective of location, diagnosis or personal circumstances."
Although the move has been welcomed by Age Concern, the charity is worried the changes do not go far enough. That's because a great deal of discretion will still be left to local health managers - some of whom have been blamed for denying care to many people entitled to it.
It's the elderly who are most in need of a change of attitude among local authorities. A report from the charity Counsel and Care reveals older people needing care in their own home are getting fewer services than a year ago and fees are rising. Some 15 per cent of local authorities tightened up their tests for entitlement to services in 2007 due to budget pressures.
"Councils want to provide the services older people need and want, but are increasingly unable to do so because central government funding has not kept pace with the demands of an ageing population," says Sandy Bruce-Lockhart, chairman of the Local Government Association. "This is not a situation that older people deserve or indeed expect."
Older people not eligible for funded NHS care are often referred to overstretched voluntary services or forced to arrange and pay privately for their care. And many that have to move into an expensive nursing home must rely on the goodwill of their family or friends, or even sell their home - around 70,000 family homes a year are sold to pay for care fees.
"Without active intervention, care and support will collapse under the strain of an ageing population and increased demand," says Stephen Burke, chief executive at Counsel and Care.
The charity says it is hoping to see the situation change, as the Government undertakes its 2007 Comprehensive Spending Review. In the meantime, older people in need of continuing care, either at home or in a care home, will need to review their own options.
If you find you have to bear most of the burden of your care fees alone, a specialised payment plan might be a suitable option. These plans convert a capital sum into a guaranteed monthly income to cover all, or part, of your care costs for as long as you need it.
Several providers offer these plans and prices vary so you should research the market before signing up. A specialist adviser with the relevant CF8 qualification will be able go through your options and help you decide on a suitable plan of action.
Free copies of the Echo guide to finding and funding a care home, sponsored by NHFA, can be obtained by calling 0870 834 7593. Calls cost under 8p a minute from a BT landline.
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