Labyrinthine care
Our reports about how NHS contractors are offering their paid consultancy services to people trying to navigate their way through the care system will have touched a chord with many readers in similar positions.
In some cases the advisers are part of the health service teams whose job is to assess whether elderly, sick individuals qualify for state help. They charge up to £300 a day to relatives who may have been turned down by the very same outfit.
Matt Hancock, the Health Secretary, has asked NHS chiefs to report on whether this is a loophole that needs to be closed. But the question they should be asking is why the system is so labyrinthine that finding a way through without expert guidance is almost impossible. One health official said that, after using her private services, a family had been awarded an NHS grant worth “thousands and thousands and thousands, like two years’ worth of nursing home fees”. This was a sum to which they were entitled but had been denied.
It is evident that families are not receiving these grants because of the complexities of the Continuing Health Care (CHC) system and the inconsistencies of diagnosis. Despite a growing number of elderly people, average eligibility for help per 50,000 population has been declining. Whether this is as a result of a deliberate effort to cut costs by denying grants to those who qualify should be established. Certainly, the confusing system does not help matters and seems designed to put applicants off. One of the “consultants” said that in about a third of the cases he handled he was able to overturn rejections for funding.
The competing interests of the NHS and local authorities, which provide means-tested care, also need to be sorted out since they are governed by separate pieces of legislation. CHC funding is clearly in need of an overhaul to make it more transparent and easier to understand.
The Government has long promised to tackle the social care issue but we still await concrete proposals. In the past 20 years, there have been five Green or White papers, umpteen policy proposals and four independent reviews. Yet hardly anything has changed, and many families still find it hard to access the care they want while staff struggle with fragmented services coming under unprecedented pressure.
Integrating health and social care is an important reform. But it is also increasingly apparent that this burden cannot be sustained by the NHS or local taxpayers alone, and more families must be ready to help support their own elderly relatives.