Committee calls for GPs to advise elderly patients on financial benefits
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《英国医生杂志》
A House of Commons committee has said that elderly people should routinely be given advice on state financial benefits when they visit their GP.
The House of Commons Public Accounts Committee, which monitors public spending, made the proposal in its report on improving public services for elderly people, published last week.
The recommendations follow a report last year from the National Audit Office, Developing Effective Services for Older People, which called for more coherent strategies across government on elderly people and for each government department to appoint a champion for elderly people, not just the NHS (BMJ 2003;326:680).
The committee抯 report acknowledges the positive impact of the national service framework for elderly people, introduced in the NHS in 2001.
But it says that other parts of government pay less attention to elderly people. The work of the Cabinet committee for older people, which is meant to draw together initiatives from across various government departments, is not publicised, it says.
It cites the New Zealand government抯 "positive ageing strategy," which sets out 10 principles for developing services and policies across government, as an example of the type of action that could be taken. But it stops short of endorsing the National Audit Office抯 call for champions for each department.
"There are more than 10 million people over state retirement age, and numbers are growing all the time," said Conservative MP Edward Leigh, chairman of the committee. "Older people are a key group of consumers for public services of all kinds."
He said that the delivery of services for elderly people was confusing and might discourage people from using them or claiming benefit entitlements.
But his proposal that people aged over 75 should have their benefit entitlements checked as part of their routine annual health check at their GP抯 surgery received short shrift from the BMA. Dr Andrew Dearden, a Cardiff GP and chairman of the BMA抯 committee for community care, said the proposal is based on arrangements no longer in place under the new GP contract.
"Under the new contract the obligation to see everyone over 75 once a year has been removed, and the responsibility lies with the patient to contact the practice," he said. "What抯 more, GPs are not benefit assessment specialists. They have no training in doing this.
"GPs are meant to be everything from a citizens?advice bureau to a marriage guidance counsellor and now a benefit adviser, as well as a doctor. Then we get whinged at when patients can抰 get appointments for three days."
However, Professor Ian Philp, the national director for older people抯 services, said that GPs still had to inform their older patients that they had a right to an annual check up.
He said that the Department of Health was moving towards a single assessment process for anyone over 75. 慖f you are the first person to see a patient who is over 75, you shouldn抰 just deal with the problem they present with,? he said, saying that a full one-hour assessment of need, including benefit entitlement, should be carried out. 態ut we are targeting practice nurses, not GPs, to do this,?he added.
The charity Help the Aged welcomed the committee抯 recommendation. "Around ?.5bn in benefits go unclaimed by older people each year," said Kate Jopling, the charity抯 public affairs officer.
"Providing benefits advice to older people in GPs?surgeries would go some way to ensuring older people claim their benefit entitlements. Help the Aged would like to see a wide range of access points for older people to integrated advice on health, wealth, and wellbeing."
The committee also said that as an increasing number of public services are made available through websites more should be done to ensure that these sites are designed appropriately for older users.(London Lynn Eaton)
The House of Commons Public Accounts Committee, which monitors public spending, made the proposal in its report on improving public services for elderly people, published last week.
The recommendations follow a report last year from the National Audit Office, Developing Effective Services for Older People, which called for more coherent strategies across government on elderly people and for each government department to appoint a champion for elderly people, not just the NHS (BMJ 2003;326:680).
The committee抯 report acknowledges the positive impact of the national service framework for elderly people, introduced in the NHS in 2001.
But it says that other parts of government pay less attention to elderly people. The work of the Cabinet committee for older people, which is meant to draw together initiatives from across various government departments, is not publicised, it says.
It cites the New Zealand government抯 "positive ageing strategy," which sets out 10 principles for developing services and policies across government, as an example of the type of action that could be taken. But it stops short of endorsing the National Audit Office抯 call for champions for each department.
"There are more than 10 million people over state retirement age, and numbers are growing all the time," said Conservative MP Edward Leigh, chairman of the committee. "Older people are a key group of consumers for public services of all kinds."
He said that the delivery of services for elderly people was confusing and might discourage people from using them or claiming benefit entitlements.
But his proposal that people aged over 75 should have their benefit entitlements checked as part of their routine annual health check at their GP抯 surgery received short shrift from the BMA. Dr Andrew Dearden, a Cardiff GP and chairman of the BMA抯 committee for community care, said the proposal is based on arrangements no longer in place under the new GP contract.
"Under the new contract the obligation to see everyone over 75 once a year has been removed, and the responsibility lies with the patient to contact the practice," he said. "What抯 more, GPs are not benefit assessment specialists. They have no training in doing this.
"GPs are meant to be everything from a citizens?advice bureau to a marriage guidance counsellor and now a benefit adviser, as well as a doctor. Then we get whinged at when patients can抰 get appointments for three days."
However, Professor Ian Philp, the national director for older people抯 services, said that GPs still had to inform their older patients that they had a right to an annual check up.
He said that the Department of Health was moving towards a single assessment process for anyone over 75. 慖f you are the first person to see a patient who is over 75, you shouldn抰 just deal with the problem they present with,? he said, saying that a full one-hour assessment of need, including benefit entitlement, should be carried out. 態ut we are targeting practice nurses, not GPs, to do this,?he added.
The charity Help the Aged welcomed the committee抯 recommendation. "Around ?.5bn in benefits go unclaimed by older people each year," said Kate Jopling, the charity抯 public affairs officer.
"Providing benefits advice to older people in GPs?surgeries would go some way to ensuring older people claim their benefit entitlements. Help the Aged would like to see a wide range of access points for older people to integrated advice on health, wealth, and wellbeing."
The committee also said that as an increasing number of public services are made available through websites more should be done to ensure that these sites are designed appropriately for older users.(London Lynn Eaton)