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Sunday, 30 September, 2001, 23:09 GMT 00:09 UK
'Free care' plans attacked
nursing home
Some people will get money to help with care home fees
The NHS will help thousands of nursing home residents with their fees from this week - but some campaigners say the new system will mean chaos.

They say many older people will see no real difference in what they have to pay.

In England, the government is to pay for the work done by state registered nurses in nursing homes - but residents will still have to pay for personal care such as washing and shopping, and for their accommodation.

Once again, older people will be the victims of this

Gordon Lishman, Age Concern England
All residents are being assessed and classed according to how much nursing they are thought to need.

The NHS will then pay the nursing home one of three amounts each week - 35, 70 and 110, depending on the amount of nursing care the resident needs.

However, Age Concern says that older people will be "bitterly disappointed" with the funding they will get.

The government has given health authorities 100m to fund the changes over the rest of the financial year.

Scottish contrast

In Scotland and Northern Ireland, their parliaments have already decided that all care should be free.

In Wales, a limited scheme to offer free personal care to some elderly people was recently introduced, but only as a measure to tackle "bed-blocking" in hospitals.

A Royal Commission on Long Term Care which reported in 1999 recommended completely free care, but this was rejected by ministers as too expensive.

We are moving away from the means test to a system determined by assessed need

Health Minister Jacqui Smith
In England, there are estimated to be 42,000 people who have to pay something for their long term care. As many as 35,000 of them pay the entire cost.

Health Minister Jacqui Smith said: "Free nursing care for all meets our NHS Plan commitment.

"We are moving away from the means test to a system determined by assessed need."

However, Gordon Lishman, Age Concern England's director-general, predicted chaos.

He said: "Once the new system is introduced, it won't be long before we start to see the complexities and mayhem that the new rules throw up.

"Once again, older people will be the victims of this."

He added: "Levels of indignation about the system have been worsened by the fact that older people in Scotland will be getting their personal and nursing care paid for.

"It is time the government finally listened to older people, and to the recommendations of its Royal Commission."

What is 'nursing care'?

There has always been debate over what constitutes "nursing" care - many have called for some ancillary work such as washing to be covered.

However, the government has used a strict definition - only the cost of work done by state-registered nurses is included.

Liberal Democrat health spokesman Paul Burstow MP described the scheme as a "cruel hoax."

He said: "Only the care given by a registered nurse will be paid for. Everything else - dressing, bathing, feeding will continue to be charged for."

We continue to be dismayed that the government chose not to support these recommendations in full

Beverly Malone, Royal College of Nursing
Beverly Malone, general secretary of the Royal College of Nursing, said she was worried that, while nursing care was free, a "ceiling" on funding for each health authority area had been set.

"Nursing care should be free to all, no matter where provided or by whom," she said.

"The RCN has always advocated for free long term nursing care, and we publicly supported the recommendations of the Royal Commission on Long Term Care.

"We continue to be dismayed that the government chose not to support these recommendations in full."

Age Concern is concerned that many older people will be "dumped" into the bottom banding - receiving only 35 a week to offset the cost of their care.

However, the government predicts that only 10% of care home residents will end up in this bracket.

The BBC's Karen Allen
"It is a complex system"
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