Admiral had to fight to get his mother the care she was entitled to
REAR Admiral Philip Mathias has encountered plenty of conflict in his life but the process of trying to claim NHS funding for the care of his elderly mother tested him “to the absolute limit”.
The former Ministry of Defence official, 60, spent two years fighting for continuing healthcare (CHC) funding that his mother Joy, 88, was lawfully entitled to for her care and treatment for Alzheimer’s disease.
She died in September, just hours after Wiltshire Clinical Commissioning Group (CCG) finally agreed it would fund her ongoing care costs.
Rear-adml Mathias, who worked as a policy director on Britain’s nuclear deterrent, said: “Applying for CHC funding was as complex as some of the nuclear deterrent policy I worked on. If someone with my experience found the process so difficult, my concern is that so many people who are applying for funding their loved one is entitled to will just decide it is not worth the stress, especially if they are also elderly themselves.”
Mrs Mathias first went into a dementia specialist home in 2014 but it was not until two years later that her family discovered she was probably eligible for CHC funding.
Under the rules, she should have been assessed on entry to the home and referred for a full eligibility test, but none was carried out.
Even when she finally had a full assessment, the tickbox system ruled that her dementia-related behavioural problems did not suggest a strong enough “primary healthcare need”.
Yet her care home records detail 170 incidents of serious aggression and violent assaults, including biting, punching and kicking staff, damaging property, throwing fire extinguishers and threatening a carer with a knife.
Rear-adml Mathias says Wiltshire CCG was simply trying to avoid meeting its financial obligations.
He won an appeal which found his mother had been eligible for funding since she first entered the home.
More than £200,000 was paid back to his father, a frail man in his 90s, who had been forced to pay for his wife’s care out of his life savings while the dispute went on.
Wiltshire CCG said it had taken action to increase the number of patients referred and found eligible for CHC funding and was now compliant with national standards.