Health authorities named for failing to investigate charges for care of elderly
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《英国医生杂志》
The UK government has named health authorities that have failed to make progress in assessing whether older people were unlawfully charged for NHS care.
The health minister Dr Stephen Ladyman reported to the House of Commons last week on the progress made with investigations into cases where elderly people may have been inappropriately denied fully funded NHS care. He said that most strategic health authorities had made good progress on this issue, with the investigations into more than 85% of cases being completed by July this year. However, he added: "Approximately 1600 cases remain outstanding, which is unacceptable."
The statement showed that one strategic health authority, Surrey and Sussex, had failed to complete nearly two thirds of the claims that it should have settled by the end of March this year. Six other health authorities (Bedfordshire and Hertfordshire; North Central London; Northumberland, Tyne and Wear; West Yorkshire; Greater Manchester; and Thames Valley) had dealt with less than 80% of the claims from older people who had required nursing care.
The right to financial redress for people who had been inappropriately charged for NHS care was established 18 months ago by the health ombudsman, Ann Abraham (BMJ2003;326:466). She estimated that more than 11 000 older and disabled people in England had been wrongly charged for care after being moved from long stay beds in NHS hospitals into nursing homes.
The situation arose after the government rejected the recommendations of a royal commission set up to look at how continuing care should be funded and decided that the NHS in England, Wales, and Northern Ireland would limit the costs of some nursing care according to patients’ financial circumstances (BMJ 2000;321:317). It was further complicated by a lack of clarity about which care home residents were eligible for continuing care—in which all nursing and personal care costs were met by the NHS—and it was judged that mistakes had been made in some cases.
Dr Ladyman told MPs last year that compensation worth an expected ￡180m ($323m; �265m) would be paid to people who had been inappropriately charged for continuing care by the end of March 2004. When this target was not met, he promised to complete the work by the end of July. In his statement last week he said that his department would be liaising with all strategic health authorities to ensure that appropriate procedures were in place to resolve the outstanding cases as quickly as possible.
Jonathan Ellis, health and social care manager with the charity Help the Aged, said: "The delay in paying people for continuing care is an example of gross mismanagement. Thousands of older people have been left at a critical point in their lives to pay themselves for care which should have been provided by the state." He added: "This debacle shows the government’s policy has not worked. Just as the NHS operates nationally, so the continuing care guidelines should have a set of national eligibility criteria, rather than be subjected to regional variation and misinterpretation."(London Susan Mayor)
The health minister Dr Stephen Ladyman reported to the House of Commons last week on the progress made with investigations into cases where elderly people may have been inappropriately denied fully funded NHS care. He said that most strategic health authorities had made good progress on this issue, with the investigations into more than 85% of cases being completed by July this year. However, he added: "Approximately 1600 cases remain outstanding, which is unacceptable."
The statement showed that one strategic health authority, Surrey and Sussex, had failed to complete nearly two thirds of the claims that it should have settled by the end of March this year. Six other health authorities (Bedfordshire and Hertfordshire; North Central London; Northumberland, Tyne and Wear; West Yorkshire; Greater Manchester; and Thames Valley) had dealt with less than 80% of the claims from older people who had required nursing care.
The right to financial redress for people who had been inappropriately charged for NHS care was established 18 months ago by the health ombudsman, Ann Abraham (BMJ2003;326:466). She estimated that more than 11 000 older and disabled people in England had been wrongly charged for care after being moved from long stay beds in NHS hospitals into nursing homes.
The situation arose after the government rejected the recommendations of a royal commission set up to look at how continuing care should be funded and decided that the NHS in England, Wales, and Northern Ireland would limit the costs of some nursing care according to patients’ financial circumstances (BMJ 2000;321:317). It was further complicated by a lack of clarity about which care home residents were eligible for continuing care—in which all nursing and personal care costs were met by the NHS—and it was judged that mistakes had been made in some cases.
Dr Ladyman told MPs last year that compensation worth an expected ￡180m ($323m; �265m) would be paid to people who had been inappropriately charged for continuing care by the end of March 2004. When this target was not met, he promised to complete the work by the end of July. In his statement last week he said that his department would be liaising with all strategic health authorities to ensure that appropriate procedures were in place to resolve the outstanding cases as quickly as possible.
Jonathan Ellis, health and social care manager with the charity Help the Aged, said: "The delay in paying people for continuing care is an example of gross mismanagement. Thousands of older people have been left at a critical point in their lives to pay themselves for care which should have been provided by the state." He added: "This debacle shows the government’s policy has not worked. Just as the NHS operates nationally, so the continuing care guidelines should have a set of national eligibility criteria, rather than be subjected to regional variation and misinterpretation."(London Susan Mayor)