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Last Updated: Wednesday, 26 July 2006, 09:21 GMT 10:21 UK
A growing scandal: Transcript
NB: THIS TRANSCRIPT WAS TYPED FROM A TRANSCRIPTION UNIT RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT: BECAUSE OF THE POSSIBILITY OF MIS-HEARING AND THE DIFFICULTY, IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE BBC CANNOT VOUCH FOR ITS ACCURACY.


PANORAMA

THE NATIONAL HOMES SWINDLE: A GROWING SCANDAL
RECORDED FROM TRANSMISSION: BBC One
DATE: 23:07:06


VIVIAN WHITE: In March Panorama reported on a national scandal. We showed how people were being unlawfully forced by the National Health Service to sell their homes to pay for long-term nursing care. We've never had such a reaction to a programme. Thousands of you emailed and called us. We triggered a wave of angry individual protests, about injustice to elderly people, about decisions by the NHS that seemed cruel, and about an unfair system that made people who'd saved up all their lives subsidised the care of those who hadn't. This is the second programme you wanted us to make about a growing scandal. By law NHS healthcare is meant to be free. But as we reported in March the elderly, with long-term nursing needs, are often forced to sell their homes to pay for it.

BIRMINGHAM

And the emails started flooding in, and amongst them was one from a viewer in Birmingham who was galvanised into action.

"Dear Panorama, I'm tried of having to keep fighting and fighting. The distress this is causing my family far outweighs the illness itself!"

PHIL SHAKESPEARE Your programme was the first time I thought I'm not being victimised. This is obviously the way the system is run, and that was when I thought well hang on, let's go that extra mile and let's get a bit of awareness for it.

WHITE: Phil Shakespeare is a printer. After he saw our programme he decided he would start a public campaign about the funding for his mother's care.

PHIL: I never thought that I would actually have to fight because these people who I thought helped you.. you know, I actually trusted these people to the point where mum's welfare was paramount and what I didn't realise is that mum's welfare is only paramount when it suits them.

WHITE: Phil Shakespeare has printed thousands of leaflets and set up a website. The campaign's objective, to restore free NHS care for his mother, Pauline. She was only 56 when dementia overtook her. Her son did all he could to help to look after her at her home. But she was becoming a danger to herself and others. She went to hospital and stayed for months and eventually she had to go into a nursing home.

[Video of a younger healthy Pauline in happy times and later, post the dementia, illustrating the complete devastation wrought by the disease]

WHITE: Pauline Shakespeare is 63 now. Her son fought for her and got free NHS care for her, but she fell and broke her hip. She was taken to hospital for an operation. But the accident had serious financial consequences as well.

PHIL: I was met in the corridor by them saying: You do realise your mum will now be reassessed for her eligibility for funding, and this was literally 24 hours after the fall and.. you know, the point at where that partial hip replacement was underway. So from that point on I realised there was more to this game than just mum's welfare.

WARE: His mother Pauline's worsening dementia meant that she was unable to learn to walk again after the partial hip replacement. But her lack of mobility made her made her easier to manage. The Primary Care Trust then told her son they were taking away her free care in the nursing home, even though the dementia, the reason for her being there was getting worse, they said that her condition was now stable, so now she'd have to pay for herself.

PHIL: Everybody sits you down and they say to you: "Look, you do realise your mum is not going to get better, she's only going to get worse, and for them to turn round and say well your mum is now stabilised, how I wish it was true, you know, so yeah, I was upset, and I realised then that I'm going to have to go through it all again.

WARE: But if Phil Shakespeare can't get the NHS to change its mind, then his mother will be means tested. Pauline Shakespeare's fees in the nursing home would amount to £450 a week. Her house in Dudley would have to be sold to pay for her care.

PHIL: Everywhere I go there's somebody who's touched by this so it's go to be a political hot potato and it's about time they actually sat up and acknowledged it.

WHITE: But Tony Blair already has. In his first party conference speech as Prime Minister he said he didn't want children brought up in a country like that.

Labour Party Conference, 1997 TONY BLAIR: I don't want them brought up in a country where the only way pensioners can get long-term care is by selling their home.

PHIL; The clip that you showed of Tony Blair in 1997 really struck a chord because, as I say, my mum and dad, you know, I watched them as a child, struggle to pay. They both worked, they paid their taxes and, you know, why the hell shouldn't they get that care that they deserve?

WHITE: So Phil Shakespeare is now campaigning on the streets because watching our last programme convinced him that the NHS was behaving unlawfully when it took away his mother's right to free health care. Whether people can properly be made to pay for nursing home care depends on where the line is drawn between health care, which the NHS must provide free, and what's called social care, local authorities provide that and it's means-tested. And as we explained in the last program, the legal test for where this line still ought to be drawn, comes down to a young art teacher who set off to school one day in 1971.

Reconstruction But Pamela Coughlan's life was to be changed forever.

PAMELA COUGHLAN I was knocked down on the way to school which wasn't much of an accident but it broke my neck.

WHITE: And Pamela Coughlan had to come to terms with being a tetraplegic for the rest of her life. It was taken for granted at the time that the NHS was financially responsible for her long-term care.

PAMELA: I need all personal care: washing, feeding, continence care, bowels, bladder. I need help to help me feed myself with a spoon in a strap. I can't breathe very well, I have to wear a very tight corset. I'm in danger of pressure marks on bottom, feet, like anywhere where there's pressure. But that is¿ that's all, that's me.

WHITE: When the NHS said that they wanted to transfer her into the care of the local council, Pamela Coughlan took the health authority to court, and in 1999 she won a landmark judgement in the Court of Appeal. Pamela Coughlan's nursing needs became the test for who should get free NHS care.

NICOLA MACKINTOSH Pamela Coughlan's Solicitor The Coughlan Test is that if your primary need is for health care, then the NHS is responsible for funding the whole package of care, that's legally responsible for funding the whole package of care. And Social Services are only legally responsible if the nursing care that you need is merely incidental or ancillary to the provision of the accommodation. So for example in a nursing home, the vast majority of people placed in nursing homes would meet the 'primary need is for health care' test, they should be fully-funded by the NHS according to law.

WHITE: And the Coughlan Test is still meant to establish who is entitled to fully-funded NHS care. But that came as an enormous surprise to one viewer: the manager of a nursing home in Nottinghamshire, Anita Astle, who was among those who e-mailed us.

Selston, Nottinghamshire

ANITA ASTLE Manager, Wren Hall Nursing Home I saw the programme on the Internet and I was amazed at how well Pamela Coughlan was and that she actually qualified for continuing health care. In comparison to the residents of Wren Hall she appears to be in a far better state of health.

WHITE: And seeing Panorama only strengthened the manager's view that her residents weren't getting what they were entitled to.

[Video footage of severely disabled elderly residents]

WHITE: Wren Hall nursing home is a family-owned business. It looks after people whose needs are too great for them to be in an ordinary residential home.

CARER: [administering medication] You want to have a drink? They'll taste horrible, Jean, if you don't swallow them. You know that.

NICOLA: Many of our residents have suffered strokes, multiple sclerosis, Parkinson's Disease, dementia type illnesses which may be of Alzheimer's type. Some people can also be terminally ill.

[illustrated with video footage]

WHITE: Anita Astle, a trained nurse herself, thinks that in view of the Coughlan Test all 41 of the residents of Wren Hall should be getting their care free from the health service.

NICOLA: All of my residents have got health needs. Their prime need is health or they wouldn't be assessed for a nursing home. Therefore it should be funded by the government. These people shouldn't be paying for their own care.

WHITE: In reality how many of your residents are actually getting free, fully-funded continuing care?

NICOLA: At the moment there's one.

WHITE: One?

NICOLA: One.

WHITE: The NHS claims that it's abiding by the Coughlan Test, but it's constructed its own elaborate criteria and it's these rules which are used to deny people free care. Maureen Britton has been in Wren Hall for 18 months.

[Distressing video footage]

TONY BRITTON My mother has Alzheimer's Disease. The official assessment of it is a moderate exhibition of the disease. I don't know how you could describe the situation you see her in as moderate. She is doubly incontinent, she is insensible to all practical purposes, she doesn't recognise me and hasn't done for probably the last 2, 3 years. The state that you see her in varies somewhat with the medication. Sometimes she'll be asleep most of the time. Sometimes she'll be very active.

WHITE: Maureen Britton doesn't get free care. Tony Britton's mother can't understand but he feels duty bound to try and inform her that he's now taking control of her financial affairs.

TONY: [to mother] Let's have a smile. Anita while you're here can we read the letter from the solicitors?

ANITA: Yeah.

TONY: Hello Mum, I need to.. I have to read you this letter, okay? Since, since Dad died I have to register the power of attorney so I can control your bank and your affairs.

WHITE: With her husband dead, the value of the family home is now at risk.

TONY: I, Anthony Britton, and I, Michael John Britton, so this involves Michael as well¿

WHITE: The house may have to be sold because the council want Maureen Britton to pay far more for her care but her son's convinced she's entitled to full NHS funding.

TONY: Alright? I wish I could understand it. They're obviously not going to give in and do the decent thing. They're going to go all out to get¿ to grab the money.

WHITE What do you mean: 'Do the decent thing'?

TONY: Well, the¿ If you, if you look at people who have worked, who have been resident in this country all their life, who have paid their taxes, who have worked continuously, who have also paid their National Insurance contributions, that surely should, should then, thereafter entitle them to any treatment they reasonably require by virtue of a medically diagnosed condition.

WHITE: But you've told us, and so have the families of residents at Wren Hall, that the NHS sometimes goes to great lengths to deny free care.

She's tired now. [calls to mother] Mum! Mum! Hello my love. Hello Mum. Have you had a nice dinner?

WHITE Peggy Wright is 84. She's suffering from dementia.

You've been trying to get fully-funded continuing care for your mother now for 2 years?

MAUREEN WRIGHT 2 ½ years, since October 2003.

WHITE And what's it been like for you trying to get it?

MAUREEN: Hard work because we're lay people and we don't understand the systems. And the NHS for instance, if we write a letter to one personnel, we'll get a reply to that letter from another. It is an avoidance strategy, you know, they're just in a way probably hoping that it will resolve itself and that my mum will pass away and they won't have to make any decisions that will cost them money.

WHITE That's what it feels like to you? They're just, I mean that's putting it bluntly saying they're waiting for your mother to die?

MAUREEN: It feels as though they're waiting and delaying.

[to mother] Would you like the music on? [touching emotional scene between mother and daughter, as mother struggles to communicate]

MAUREEN: We're lucky that she's still with us really.

Thank you, darling. [responding to mother's weakly indicated desire for a kiss]

Bagshot, Surrey

WHITE St Anne's Church in Surrey. The refusal of free NHS care has provoked outrage all over Middle England. Now that anger is being voiced. For some, the way the NHS is behaving is a moral issue. Lynne Cowley emailed us as well.

LYNNE COWLEY The Bible says that you can test the moral health of the, of society by the way it treats its most vulnerable people. We're not treating vulnerable people very well at all. Older people become invisible and they have no voice and if they are told things they don't challenge, they don't question and I think that they get walked over.

WHITE Earlier this year, Lynne Cowley's mother was admitted to hospital. Gladys Richards is 87. She has dementia and Type I diabetes.

LYNNE: [to mother] I've brought you some more juice, look. Yes, I've brought your favourite.

WHITE The diabetes had given Gladys Richards circulation problems. Because of these, she got gangrene in one foot. It was decided that she needed to go into a nursing home. Her daughter claimed that she was entitled to free NHS care and the authorities agreed.

LYNNE: The lady from the Social Services rang me and she said: "Put the champagne on ice, we've won!" And I said: "Can you spell that out for me?" and she said: "Yes, your mother will be fully-funded by the NHS."

WHITE: Why did the woman from Social Services who rang you put it in quite the way she did?

LYNNE: I think it's because they don't often win these cases and she could see how seriously ill my mum was.

WHITE Did she say it was a rare event?

LYNNE: Yes.

WHITE I mean what, what did she tell you?

LYNNE: Yes, she said we don't often win. And so I thought that that would be the end of it, but then of course my mum's condition deteriorated.

WHITE Lynne's mother's gangrene got worse. So much so that part of her right foot had to be amputated. That operation wasn't sufficient. Another followed and this time most of her right leg was amputated.

GLADYS: [confused] I mean, it's your caravan.

LYNNE: [to mother] No darling, you're not in the caravan. You're in hospital.

WHITE: The NHS reassessed Lynne's mother after the amputation and she was told that now Gladys Richards wouldn't be eligible for fully-funded care after all.

LYNNE: I couldn't understand why because by now she was worse off than she was when she went in to hospital. And it seemed to me that it was quite brutal and it was, you know, more or less a case of: 'Well, we've chopped your leg off, so we're cutting the funding.'

WHITE Their argument is that when they granted her fully-funded care, her health needs were as they put it: "Complex and intense." Now they say her health needs are: "Stable and predictable within a given range" What do you think of their argument?

LYNNE: I think it's absolute rubbish. She does have intense needs. Nothing much has changed, except for: she has lost a leg. She still has dementia, she still has Type I diabetes, she still cannot do her own injection, she cannot administer her own medication. She has very intense needs.

WHITE Assessments that the NHS carries out in cases like this to deny fully-funded care, can often be unlawful because they don't conform to the Coughlan Test.

NICOLA MACKINTOSH Pamela Coughlan's solicitor I can't comment on individual cases. What I can say is that use of those sorts of words perpetuates a myth which has been built up for decades. That's not the test. The test is, the Coughlan Test, which is: Is your primary need for health care? And words such as unpredictable, complex, intense, etc. all serve to perpetuate that same myth which means that many more people fall below the threshold and don't qualify for fully-funded NHS care. And that's unlawful.

WHITE Lynne Cowley's mother, Gladys Richards, died on July 1st, only 2 months after the NHS's decision that she wasn't entitled to fully-funded care. The funeral took place on Tuesday. The Primary Care Trust have told us in a statement that they adhered to the criteria at each stage of her care. They say that they appreciate that for her family, the individual conclusions from these assessments may have seemed confusing. Families up and down the country have told us of their distress at learning that they must pay for what looks like health care to them because the government insists on defining it as social care. Wouldn't it be more straightforward for the government to stand up and say: 'The elderly long-term sick are now going to be asked to pay towards the cost of their health care.' That's what the policy actually is, why not say so?

IVAN LEWIS MP Health Minister for England and Wales Because in all cases that isn't the case. I mean if you look at continuing care, if you look at nursing care in nursing home settings, the government is actually willing to make a very, very significant contribution. In terms of social care, there has always been a means testing approach to those issues and I would contest honestly, in terms of the public, that no government could suggest that social care could be offered free to everybody, it's not going to be affordable, nor realistic.

WHITE According to the government then, most of the residents at Wren Hall and other people like them don't need health care, only social care. The NHS does no more than make a financial contribution towards the time that they're cared for by registered nurses. And that means that years after the legal line for entitlement to free care was drawn, very ill people in Wren Hall get means-tested for most of the cost of their own care.

[Video footage of desperately feeble people being assisted to eat]

CHRIS: Is she swallowing? She wasn't swallowing there. Wendy, here you are sweetheart.

WHITE: Are the sort of people whom you're looking after here, the residents, are they much the same as they always were or have they changed?

CHRIS BATES Care Assistant No, they've changed drastically from when I first came.

WHITE What do you mean?

CHRIS: Well, I've been here, what, 16 years, I mean and we had a lot of mobile, they could do things for themselves, you know, but now the biggest majority are all dependent on us and we have to do everything.

WHITE But as the condition of the residents in nursing homes has gradually got worse, the chances of the NHS giving them free care seems to have reduced.

ANITA: It's the same in all homes, particularly in nursing homes so the dependency has increased and also what seems to be happening is that assessment criteria's have been tightened¿

WHITE So you're saying the hurdle's being raised all the time?

ANITA: Definitely.

West Kirby, The Wirral

WHITE: And self-funders who sell their houses and use their savings to pay for their care get a rough deal in other ways too. Linda Jones from the Wirral was in the middle of writing to the Prime Minister about her uncle and what had happened to him when she saw our programme.

LINDA JONES: "Dear Mr Blair, to date we have paid in excess of 45 000 in fees for an uncaring service, believing that we were doing our best. We've had the door slammed in our faces all the way. We've now sold the family home, what more do you want us to do?"

WHITE Linda Jones's Uncle Ernest was a family favourite. He owned a small shop in Tranmere on Merseyside.

LINDA: It was a general store, bit like Arkwright's but it sold all sorts of food produce, bakery cakes. He had savings, he had a home. Obviously he sold his shop and that's where his savings came from, when he retired.

WHITE: But Uncle Ernest began to have increasingly severe headaches and to exhibit bizarre and dangerous behaviour. He was having a series of mini-strokes. There was no alternative but to put him into a home.

LINDA: [to Uncle Ernest] Look into the camera. Go on, where's the smile¿

WHITE There was no assessment for fully-funded care, it wasn't even mentioned. The authorities took it for granted that as a property owner, Uncle Ernest would fund himself. Then his nursing needs became too great for the home he was in. Linda Jones was told she'd have to move him.

LINDA JONES So I rang Social Services and it was: "No, he's self-funding, you can't have a social worker and there's no reason why the nursing team can't come out to assess him." And I said: "Well, I'm getting passed from pillar to post', and I said: 'I'm really getting frustrated." I said, you know: "Where do we go from here?" and one of the social workers said that: "Well, perhaps if you take him to Accident and Emergency and leave him there with his name and address on, he then would get into the system, the health service, healthcare system." And I just¿ stunned.

WHITE She found another home for her uncle but within days Riversdale said they couldn't cope with him either. They say the previous home misled them about his deteriorating condition. So one night in February, Linda Jones and her 72-year old mother had to move Uncle Ernest all over again by themselves.

Reconstruction LINDA: We came into the home and he was sitting away on his own with his coat and his hat on. His possessions were in plastic bags. It turned out he'd also been heavily sedated. His legs were going in all sorts of directions, it's like¿ And he has a tilt from his stroke. And we had to keep reassuring him all the time cos he was terribly distressed. And then he froze on the spot, cos he really did panic.

WHITE Linda Jones and her mother struggled to get Uncle Ernest in her car.

LINDA: He was shaking, his body was twitching. He kept pulling the door, trying to get out the door whilst we were driving to the new place. And then with the distress of it all and everything he, he soiled himself quite badly. It seemed like the longest journey, because you've got a loved one in the back and you're just trying to get the best for them.

[to Uncle Ernest] It's a bit quieter in here isn't it?

WHITE: Uncle Ernest is settled in his third home now and receiving the care that he needs.

LINDA: [to uncle] Remember your shop? Remember when you were in Tranmere?

ERNEST: What's that?

LINDA: When we were little we used to work in your shop with you, in your shop in Tranmere. Do you remember? Can't you remember it? That used to be your favourite place, the shop, didn't it?

WHITE But the lesson Linda Jones has been taught is that the system can leave self-funders with serious health needs completely on their own.

WHITE Were Social Services there for you?

LINDA: No, no.

WHITE Was the NHS there for you?

LINDA: No, absolutely not.

WHITE So what was the message to you?

LINDA: "Get on with it, get on with it. He's, you've got money, you've got savings, you've got property, you know, you have to fund it." And that was the message, that was the message I've got wherever I've gone since, whatever I've done since: "Get on with it."

WHITE Linda Jones hasn't received any reply to the letter she wrote to the Prime Minister. But since she e-mailed us and we took an interest, something curious has happened. This month, out of the blue, she got a phone call from the NHS. Her uncle's now been granted fully-funded care, subject to regular review. You felt the system wasn't there for you?

LINDA: It wasn't.

WHITE Now you've had this phone call.

LINDA: Mm, that's right.

WHITE What do you think has made the difference?

LINDA: Panorama, media interest. There can't be any other reason because all avenues were closed to me prior to that.

WHITE Wren Hall nursing home illustrates another problem that lots of you told us about: self-funders, those who saved to buy their homes, not only pay for themselves but they often pay more. George Samen is 93. He's got dementia. He can't walk independently but he tries to so he's at risk of falling. Rachel Moltby is 90. Her condition is very similar. The other thing they've got in common is that they used to be next door neighbours. Their daughters also know each other well.

MOLLIE HUNT Rachel's daughter My mum's been here 2 ½ years. George came at Christmas¿

JUDITH: Just before Christmas he came here, didn't he?

MOLLIE: Yeah, and we were amazed. And what, it was lovely, you know (laughs). I said: 'You're back together again, you know, after all this time you're back.'

WHITE The 2 families both lived nearby in Selston Village. Number 18 Victoria Street, was Rachel Moltby's house. Her husband was a lorry driver. They rented their home. And next door, number 20, was George Samen's. He owned his house. George worked at the local coal mine, first underground and then after an accident, on the surface. Now Rachel Moltby's fees in Wren Hall are paid for by the county council. But George Samen, who saved and bought his house, is a self-funder. The council's basic rate for Rachel's nursing home care is £343 a week, but George's fees are £425 a week. Self-funders pay far more for the same level of care.

MOLLIE: Which is totally wrong as far as I'm concerned, they should all get it.

JUDITH: Yes, they should.

MOLLIE: They shouldn't differentiate between one and the other. They've all worked hard all their life. Unfortunately my parents weren't in a position to buy the house that they were in, Judith's dad was.

WHITE So, Judith, Molly doesn't think it's right¿

JUDITH: No

WHITE ¿ that you're paying 425 pound while Social Services are paying 343 pound in Rachel's case.

JUDITH: Yes.

WHITE What do you think?

JUDITH CRITCHLOW George's daughter Oh, I think it's dreadful. I'm seeing my dad's money¿ well I mean, he's never earned a lot of money in his life, do you know what I mean? I mean I think when he finished work, when he was 63, he was earning about 17 pound a week at the, on the pit top. You know it wasn't that he'd earned a lot of money, but he's always been a saver, all his life he has saved and he's loved saving really (laughs) hasn't he.

MOLLIE: (laughs) Yeah.

JUDITH: But you know, he has enjoyed saving his money and now it's being taken off him and I just see it and I think: 'Oh, it's dreadful, it really is.'

WHITE George's savings are being gradually drawn down. Next, his house will have to be sold. Wren Hall's a family-owned business. They say the problem is that the rates the council pays for care, are unrealistically low.

ANITA: [Wren Hall staff meeting] Ruby's Zimmer frame's broken, does anybody know¿

WHITE They say that they have no choice but to make the self-funders pay more than the rest. Lots of other care homes do just the same.

And now you're self-funders are paying more, considerably more than those people who are here funded by Social Services. Are the self-funders subsidising the rest?

ANITA ASTLE Manager, Wren Hall Nursing Home I don't know whether¿ They are paying more, they're paying the true cost of care. In blunt terms the answer is probably yes. But in reality at Wren Hall we don't make the profit that we should, and I would argue that in not making the profit, that by taking in people that are Social Services funded, we're actually subsidising them by taking a reduced profit.

WHITE We've had a flood of emails from self-funders. You complained about an unfair system that forced people with savings to subsidise the care of those without them, and you said that insult was being added to injury because the care should have been free in the first place. People who'd always trusted the NHS told us that now they no longer did. But, as we reported in our last program there was some hopeful news as well because Matthew Grogan, a London taxi driver, had mounted a new legal challenge to the system. His mother's in a nursing home in Thamesmead in South London. She has deteriorating multiple sclerosis and dementia. He'd already paid £90 000,00 towards her care and sold her house to do so, but he couldn't bare to tell her.

Panorama 5th March 2006

MATTHEW GROGAN It's heartbreaking and I've not been able to tell her. It's a horrible thing to have to do to go and visit your own mother, that brought you into the world and done everything for you, and then every time I go and visit her I've got to lie. I've got to lie to my mum every time.

WHITE Matthew Grogan went to the High Court, claiming his mother's assessment had been unlawful, and he won. The judge, Mr Justice Charles, said that the NHS's criteria had been: "fatally flawed." They should be rewritten and she should be reassessed. That was in January. The government was forced to issue new guidance to health authorities. A fortnight ago Matthew Grogan heard from the NHS. They have reassessed his mother and they've refused her free care all over again.

MATTHEW: Yeah, I'm disgusted. Absolutely, totally gutted by it, confused, and upset. I just, you know, it just seems a little blip in it and we, we've got to carry on fighting. That's all we can do, just carry on.

WHITE And what do you think about the whole system now? Now you've experienced it?

MATTHEW: Confusing and unfair. I've, we basically find it very unfair that some pa', you know, some people that are in, whose condition is less than my mother don't have to pay, yet my mother's still deemed to pay.

WHITE So there's likely to be another round in the legal battle over the Grogan case. In the face of all the criticism, the Department of Health has now brought out a new so-called National Framework for consultation. But the system will remain essentially the same. The government says that, quote: "The National Framework will not change the extent of services that can be provided free of charge, nor will it alter the underlying policy."

It's widely believed that this is an elaborate deceit. People are being told that they're getting social care when it's plain as a pikestaff that they're getting health care and the legal line is being ignored and people can see that.

IVAN LEWIS MP Health Minister for England and Wales Well, I hope that that isn't the case. I believe that the guidance that we're consorting on at the moment, the new regime, will help to make people feel better about the system. But in the end, obviously at a local level, people should be assessed according to their needs and if their needs suggest they require continuing care, that should be funded, the same with nursing care. But equally if it's really about some social care to enable people to live independently, then social care in this country, since the health service was created, has always had an element of means testing and it wouldn't be affordable simply to offer people a free system.

WHITE So under the new National Framework, do you anticipate that people will still be denied free health care who are entitled to it?

NICOLA: Yes.

WHITE Under the new National Framework, do you anticipate that people will still be forced unlawfully to sell their houses to pay for health care that should be free?

NICOLA: Yes.

WHITE So the scandal of continuing care that you've drawn attention to, goes on?

NICOLA MACKINTOSH Pamela Coughlan's solicitor Yes. And this is a missed opportunity. Instead of all the doctors, all the nurses, all the social workers, the relatives, carers and residents being put through the agony of continuing injustice, it would be much better if that money which was spent on resolving disputes, doing assessments, was actually spent on health care.

WHITE Most of the elderly in nursing homes can't protest for themselves. But their children, mature voters, can. And the response that we had to our last program on continuing care shows that increasingly they will protest.

LYNNE: I don't think that we should put up with state sanctioned theft. It, it's just not fair for people who've worked all their lives, paid for themselves, paid for, you know, their taxed, fought for their country, and they're just walked all over.

TONY BLAIR: [1997] I don't want them brought up in a country where the only way pensioners can get long-term care is by selling their home.

TONY BRITTON: You showed a clip of Tony Blair in 1997 saying that the situation shouldn't exist and yet it plainly it does exist, not nearly 10 years later. That's a significant breach of confidence I would have thought, and the electorate I, I think should take note of that.

WHITE These protests are growing louder. The scandal of forcing people to sell their houses to pay for care that should be free, could be costly for the government as well.

You can find more information about tonight's program or tell us your own stories by visiting our web site.

If you've been affected by any of the issues in tonight's program and would like to talk to someone in confidence, please call the BBC Action Line on 08000688456. That's 08000688456. Lines are open 7 days a week from 7.30 am until midnight. All calls are free and confidential.

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How the world's oldest clove tree defied an empire
Why Royal Ballet principal Sergei Polunin quit


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