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Thursday, August 13, 2009

The hidden scandal of unfunded nursing care

The BBC report on the outcome of a six-year legal battle, in which a family has succeeded in recovering more than £165,000 in nursing fees which were wrongly paid.

Marjorie Eyton-Jones from Benllech, Anglesey, who had Alzheimer's, was admitted to a home on the Wirral in 1998, but had to pay for her care. Her family was forced to sell her home to fund the nursing fees until her death at the age of 88 in May 2007.

The judgement is a landmark case that could have wide-ranging ramifications for the National Health Service and hopefully beneficial implications for families in the same situation as those of Mrs Eyton-Jones.

I have acted on behalf of a number of constituents in the past who have been in a similar situation. They have had a relative suffering from a long-term illness such as Alzheimer's, which has necessitated residential care. To pay for this they have had to sell the relative's property and use up his or her savings.

In these cases the Local Health Board has argued that despite the fact that the patient needs 24 hour care because they are in a residential home as opposed to a nursing home then the NHS is not responsible for the cost of that care. It is an argument that has been shown up to be erroneous by this judgement.

Anybody who leaves hospital should receive a continuous care assessment, which establishes their nursing and personal care needs. Any nursing care needs identified by this assessment should be paid for by the NHS. Members of the family are entitled to be present at this assessment. The problem is that most do not know of this requirement and are in any case preoccupied by other matters. Often these assessments do not take place.

Like everything else these days the root cause of these assessments being overlooked is money. The NHS is responsible for paying for nursing care, local authorities often pick up the bill for social and personal care. Thus the outcomes of these assessments can often be significant in determining who pays.

What is missing here is clarity. It seems to me that there is no clearly understood definition of nursing care and personal care. Locak Health Boards might say that there is but it is difficult to believe that they are right when they argue that care that is delivered in a nursing home can be funded but identical care in a residental home cannot.

Familes who are in a similar position to that of Mrs Eyton-Jones now need to ask their local health body to carry out a continuing care assessment and take on funding the nursing care of their relative. That however is not enough. The Government needs to act too.

Ministers must now offer some clear guidance to families and to health and social care professionals on what can and cannot be funded so that there is no confusion in future. We cannot expect relatives to have to resort to lengthy and expensive court action every time there is a dispute.

I would hope too that there could be some increase in the maximum amount of capital a patient can hold before being charged for care and that some resolution procedure can be put in place to sort out disputes on payments between local councils and health bodies. I have already written a motion for the next Welsh Liberal Democrat Conference on this issue.

This court case means that doing nothing is not an option. Once the Assembly reconvenes I will be seeking answers from the Health Minister as to how she will be responding to it. I hope that members of other Parliaments and Assemblies will be doing the same.
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