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Care Inequality : Some Pay , Some Don't : Depends On Illness ? - Carers UK Forum

Care Inequality : Some Pay , Some Don't : Depends On Illness ?

Share information, support and advice on all aspects of caring.
Interesting article from the Yorkie Post spelling out the " Anomalies " in the NHS / social care system ... caused by them being demerged over the decades :

https://www.yorkshirepost.co.uk/news/op ... -1-9083904

Andrew Vine : Care inequality puts high price on some illnesses.

JOHN’S once-formidable mind is fogged by dementia now, and as he goes into full-time care, one of the comforts that his family draw is that he won’t know how much it will cost.

Like any parents who worked hard all their lives, he and his late wife intended that their estate would go to their children and grandchildren. It won’t now, or at least not all of it, because care costs will probably swallow his savings and a large chunk of the sale of his house.

This would have distressed him terribly, and for his family, it is a mercy that he is no longer able to appreciate it.

Norman, on the other hand, who has just been diagnosed with cancer, comforts himself that whatever lies ahead, his family will inherit all he has, because the first-class care he is now receiving from the NHS won’t cost him a penny.

The contrasting fates of these two old friends of mine, both in their late 70s, neatly sums up the dilemma of how Britain pays for the care of people in need.

Without intending to discriminate, we have drifted into creating a hierarchy of illness. Some are deemed worthy of the state picking up the costs of care, whilst others strip sufferers not only of their health, but of their wealth too.

Contract cancer, or any other condition requiring medical care, and the state will do its utmost to help, free of charge.

But develop a long-term condition that requires care outside a hospital, and if you have any means, you’re expected to foot the bill.

It’s an iniquity that is intensely frustrating for the families of those who have to pay. The generations now needing help in old age embody the values championed by successive governments of doing the right thing in working hard, saving and planning for retirement.

Except nobody told them that in the twilight of their lives, much of what they had would have to be spent on care instead of being passed on to the families for whom they had worked so hard.

And this is a problem that is only going to get worse. The Government’s own figures show that one in 10 people in care already have to find more than £100,000. That proportion is bound to rise, because in 20 years’ time, the number of people aged 85 or over is projected to double, thanks to advances in medicine.

Inevitably, that is going to place both the NHS and the social care system under additional strain, when both are already creaking.

The pressures are starkly illustrated by the fact that it is now common for two-thirds of all council budgets to be spent on providing social care.

The problems of social care, and its long-term funding, were discussed yesterday by the Housing, Communities and Local Government Select Committee.

And Health Secretary Jeremy Hunt told an audience of social workers last week that the Government’s Green Paper on the issue, due this summer, would set out options for the future.

He also said it would include proposals for a cap on costs for those paying for care, but there was no indication that the Government intends to address the iniquity that sees the NHS pick up the bill for caring for some long-term conditions but not others.

Whatever the detail of the proposals, they are going to have to be pretty radical if they are to address what is becoming a crisis.

More than 30,000 care home places have been lost over the past decade because owners have been unable to afford to keep them open with the funding provided by the state.

One consequence of this has been a huge increase in bed-blocking in hospitals, because elderly patients ready to be medically discharged, but still in need of care, have nowhere to go.

This is a dreadful mess that the Government needs to tackle urgently. It is the result of a lack of joined-up thinking that has only recently started to be addressed, with Mr Hunt being given responsibility for social care, as well as health, in January.

This was long overdue, and the benefits of linking the NHS and social care systems have been proven by a pilot project in Manchester which has drastically reduced bed-blocking.

It has also cut the number of elderly people needing to be taken to accident and emergency departments by forging closer links between care homes and GPs.

The success of the pilot points the way forward for other areas, but there still needs to be a fundamental rethink of the care system, both in terms of capacity for an ageing population, and how it is funded.

Suggestions of a tax specifically to fund the NHS are gaining support across all the major political parties, but it will not begin to address Britain’s care crisis unless the money is also found to look after the country’s elderly without a disproportionate reliance on their savings.

A voice of common sense ?


The alternative does not bear thinking about !
The situation is even more blurry around mental health issues. There are moves afoot to "demedicalise" conditions such as Autism that are neurologically there from birth, but how does one then regard brain injury there from birth, or schizophrenia which manifests itself in childhood. Some of these need the kind of care that medicine and nursing provides coupled with social care. Very blurry indeed
Depends on how much less the Government wants to spend on the NHS and social care ?

Why anyone with some financial muscle has not sought to challenge the Government on it's " Split " policy on illnesses is beyond me.

Perhaps in the near future all NHS establishments and GP surgeries will have a sign up :

Those treated free of charge ... detailed list.

Those treated depending on your ability to pay ... detailed list.

If the Government do . indeed , want to spend less , just shift a few " Illnesses " from one column to the other ... in a similar way to the NHS having stopped providing prescriptions for many medications ?

A two tiered NHS system in more ways than one ... right here and now ?
An article from today's later edition of the Guardian online.

I chose this thread as it follows the flow ... some " Illnesses " are considered free under the NHS but others are not.

If social care is provided by the NHS whilst the patient is in hospital , WHY is that free ???

I did post a reply received from the NHS on that score sometime ago ... still searching as I type.

https://www.theguardian.com/commentisfr ... th-lottery

Mum has dementia and now Dad’s dead she will have to sell her home ...why ?

Britain operates a cruel health lottery that discriminates against dementia patients. Struggling families need social care.

When my father died suddenly in January at the age of 91, family and friends gave him a great send-off. We had a private cremation, an uplifting memorial service at church, and rounded off the day with a buffet at the golf club. The next day, Mum couldn’t remember anything about it. She kept asking whether Dad had died, how he had died, and obsessed about having to organise the funeral.

About 10 years ago Mum was diagnosed with dementia, the creeping and cruel illness that has stolen her short-term memory although not – yet – her vibrant personality. Thanks to round-the-clock care by my father, her memory problems worsened only gradually until his death. But in grief, her confusion has deepened significantly.

In the first weeks after he died, my brother and I would have to relive every few minutes, in response to questions from Mum about how he’d fallen down the stairs and knocked himself out. She kept on discovering for herself that he wasn’t there. Once she wandered into my bedroom in the middle of the night with her handbag under her arm, saying she was going to call the police because Dad was missing.

The doctor said that we should start with a social-needs assessment by the local authorities, which would help us with a care package. However, they told us that Mum would have to consent to an assessment by phone, which seemed surreal given her belief that she was running the household unaided. More than two months later we are still waiting for a face-to-face appointment and have been navigating the system on our own. One of my first discoveries was that because my mother has more than £23,250 in personal assets, including her house, she would be among the hundreds of thousands of “self-funders” forced to pay all her costs if she ended up in a care home.

While I was in the process of talking to care agencies and visiting homes trying to find out what would be in her best interests, Mum – who is very mobile and fit at 89, despite her condition – had a fall. She spent a day in hospital, which prompted us to take the wrenching decision to find a place for her in a residential home where she would be safe. How quickly we had reached the point where suddenly we were going to start burning through money and face the “catastrophic” costs recognised by the Dilnot commission in 2011.

Like so many others watching their savings being wiped out, I feel that our situation is unfair because dementia is an illness for which there is no cure and which strikes at random. My father never claimed a penny as one of the cohorts of unpaid family carers who now total 8% of the UK population. If Mum had been diagnosed with cancer, she would have received free care on the NHS, but with dementia she’s having to fend for herself. Why should she be penalised when others with a different illness are not?

Nothing has been done to reform this arbitrary and unjust policy of adult social care since the Dilnot commission recommended a cap on lifetime care costs and a more generous means test. After the coalition government backed the principle, Theresa May last year postponed the reforms that would have limited individual liabilities. Now the best chance for overhauling the funding system will be in a long-awaited green paper in May or June – which the government has said will contain options for asset caps and a means-tested floor.

With May proposing £4bn a year in extra spending for the NHS, Jeremy Hunt spelled out on 20 March his seven principles, in which he said social care should be the shared responsibility of the state and the individual. Adult social care has been led by local authorities since 1990 but now they are struggling to cope with budget cuts as well as the needs of a swelling elderly population living longer than ever. Having lost his grandmother to dementia, Hunt said he wants to end this illness “lottery”, which defines financial wellbeing under the current punitive system.

He hinted that younger people might take out social insurance for their care needs in old age, as part of an “equitable” approach to funding. Other options, also reviewed in a recent working paper by the King’s Fund, could include a dedicated tax for social care, including a possible tax on people’s homes after they die.

Resolving the social care crisis with a long-term financially sustainable approach will take time. It will cost billions and will be too late for my Mum, who will have to sell her house if she stays in the care home.

Why should young people care, saddled with debt from university fees and struggling to get a foothold on the housing ladder? Because dementia is a timebomb the devastating effects of which are being felt by families across the land. With cases steadily approaching the one million mark, it’s time for solidarity across the generations. We all pay for education, whether or not we have children. Whatever solution is found for social care in the future, it must be earmarked and include the principle of “we all help one another”.

COMMENTS SECTION ... recommended !!!

Bottom line ?

Recombine the NHS and social care ... funded through general taxation ... free at the point of delivery.


Even bigger question ... whose responsible to protect their citizens in times of sickness and health ... the Government , or the citizens themselves through that age old party trick " The Family ? "
Funny, i thought social assurance and a tax to cover social care was already in place and is called National Insurance, and currently costs workers 12% and their employer 13.4%