United Kingdom: Charity Attacks ‘Care Lottery’ for Elderly

By Sarah Womack, Telegraph.co.uk

United Kingdom

July 15, 2007

Elderly people in some parts of Britain are up to 160 times more likely to have their bills for long-term NHS care paid for by the health service than others.
The unjustifiable postcode lottery was a public scandal and "beggared belief", said Age Concern, which obtained the information from the Department of Health.

The issue of who pays for "continuing care" is highly contentious as thousands of elderly people have to use their savings or even sell their homes to pay bills, while others get their care for free.
It is estimated that more than 70,000 elderly people have been forced to sell their homes.

Continuing care is defined as where the NHS is responsible for, and fully funds, health care outside hospital. It mostly affects very ill, older people in nursing homes, but the NHS can also fund care in a person's own home.

Age Concern's analysis of continuing care figures shows that in March, Derby City Primary Care Trust was giving just seven people continuing care, a figure which represents 0.26 people per 10,000.

Age Concern contrasted the figures with Harrow, which was giving 826 people continuing care, at a rate of 41.75 per 10,000 people, 160 times higher than Derby.
Gordon Lishman, the director general of Age Concern, said: "There can be no justification for such huge variations."

Ivan Lewis, the care services minister, said: "These figures from Age Concern are not new. We are aware of the variation, which is exactly why we published the National Framework for NHS Continuing Healthcare only two weeks ago. This will take effect from October 1 this year.

"The new framework will help ensure that all the people who are eligible for NHS Continuing Healthcare or NHS-funded nursing care will receive the care they need."

Age Concern says the new criteria will increase the number of people receiving continuing care by about 7,000 to 31,000, at a cost to taxpayers of £220 million. But it estimates it will still leave 60,000 people missing out on care to which they are legally entitled.

The charity said older populations within PCTs were not a factor in higher levels of continuing care.

Mr Lishman said: "The new framework is welcome but we want to see it monitored carefully, and greater pressure put on Strategic Health Authorities and local authorities to ensure that there is a seismic shift in attitudes in those PCTs that give low numbers of people continuing care."

The changes from October may bring more consistency but would "still leave much open" to the attitude of PCTs.

"Our analysis shows individual PCTs currently interpret their own guidelines very differently," said a spokesman. "Even in the same Strategic Health Authority, using the same criteria, PCTs can be 15 times more likely to give continuing care than other PCTs."

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