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Sunday, 30 September, 2001, 23:28 GMT 00:28 UK
Q&A: 'Free' nursing care

Monday is the day from which people paying for their own care in nursing homes may get some help from the NHS to pay their bills.

BBC News Online outlines the main changes, and what these will mean to residents and their relatives.

Who will be affected by the changing rules?

Potentially, anyone living in a nursing home or residential home who receives "medical nursing" and is paying for this with their own money.

Broadly, there are two types of ways that residents of these homes are looked after by staff - medical care and personal care.

Medical care covers the work carried out by registered nurses in homes - such as giving out medication, give injections, or dress wounds.

Personal care covers work normally carried out by care assistants, such as washing and dressing.

The changes only cover the medical care offered to residents.

The NHS says that residents should not be have to pay for these services, which they would receive for free anywhere else in the health service.

Who currently pays for their care?

People who have more than 18,500 in "capital" - perhaps tied up in the value of their house, or in savings, have to pay the cost of staying in a nursing home.

People with less money than this qualify to have home costs paid by the local authority.

How will it be assessed?

Everyone currently in a home, or entering a home from Monday should have an assessment to work out how much medical nursing care they need.

On the basis of this, they will be placed in one of three bands - 35 for those needing relatively little nursing care, 70 for those needing more, and 110 for those needing the most intensive nursing care.

If they are paying for it themselves, the home will be given this amount weekly - and the home is expected to reassess weekly fees to reflect this.

The home resident will, of course, still have to pay the remainder of their fees, covering personal care and accommodation.

And, if the assessment falls short of what the home is spending on a resident's nursing care, then the resident will still have to pick up the bill for the difference.

The figures quoted by the government are merely what it thinks is a fair price for the amount of care the resident is getting.

The Royal Commission on Long Term Care wanted all care in nursing and residential care to be free. Why has the government decided not to do this?

The government has certainly been heavily criticised for its decision not to follow the Royal Commission recommendations.

This would have cost it an estimated 1bn, and it says it felt this vast sum of money would be better off spent elsewhere, such as helping older people live independently at home.

However, people in the same position in Scotland will have all their care, medical and personal, paid for, after a decision by the devolved Scottish Parliament.

See also:

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