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Welfare Reform on the Web (August 1999): Care of the Elderly - UK

FROM A PERSONAL POINT OF VIEW: THE ROYAL COMMISSION'S PROPOSALS FOR LONG TERM CARE OF THE ELDERLY

Anon
Working with Older People, vol.3, April 1999, p.7-15

Summaries the Royal Commissions report "With Respect to Old Age", shows the growth in the elderly population, details the costs of caring and lists the commission's recommendations. The main recommendations are:

  • free personal care paid from taxation;
  • means-tested living and housing services;
  • a National Care Commission;
  • pooled budgets;
  • a national carers support package.

THE LONG TERM CARE OF THE ELDERLY

Health Committee
London: TSO, 1999 (House of Commons papers. Session 1998/9; HC 318)

Supports the general approach of the Royal Commission on Long Term Care that personal care should be distinguished from living costs and housing costs. Agrees in principle that personal care should be provided free and funded from general taxation. Recommends that care in the home should be made available to older people for as long as possible. The development of multi-skilled teams of support workers, similar to those employed in Denmark, would assist this process. Suggests looking closely at Danish models of care for older people with a view to extracting relevant ideas.

NATIONAL CARE HOME STANDARDS: ISSUES OF QUALITY AND SIZE

G. Dalley
Working with Older People, vol.3, April 1999, p.21-23

Introduces the 'National Required Standards for Residential and Nursing Homes for Older People' drawn up by the Centre for Policy on Ageing. Their aim is to lay down standards which are reasonable and acceptable in practice. Reaction to the proposed standards has focused on their requirements for minimum room size. Faced with increasing competition, care home proprietors fighting against these are being short sighted.

OFFICIAL POLICY TO DISINVEST IN LONG TERM CARE? AN OPPORTUNITY FOR MARKET REFORM

R. Lorimer
Registered Homes and Services, vol.3, 1999, p.179-181

Points out a subtle change in government funding of Social Services Departments that will mean that resources will be switched from paying for residential care to development of alternatives to hospitalisation or long term institutional care. The independent sector needs to respond by remodelling services towards rehabilitation and provision of intermediate care.

PILOTING BEST VALUE AND BETTER GOVERNMENT FOR OLDER PEOPLE IN EXETER

J. Kelly
Managing Community Care, vol.7, April 1999, p.25-32

Article reviews the Best Value Project which involves principal public agencies in the city. The project has promoted widespread public consultation and the first six radical service reviews are under way. The Better Government for Older People Project has specifically aimed at improving older people's ability to take part in consultation via a Visioning Day and the setting up of two focus groups to review transport for older people in the city and ways to improve communication with older people by public agencies.

ROOM SERVICE

M. Hake
Registered Homes and Services, vol.3, 1999, p.182-183

Explores providers' concerns about the draft national required standards for care and nursing homes for older people presented to the government in January. There has been a measure of orchestrated provider concern about the proposed standards for staffing, training, room sizes and shared rooms. The draft standards are said to be a threat to the viability of homes, a source of market instability, or unaffordable.

RULING REOPENS ELDERLY FREE CARE DEBATE

D. Harding
Public Finance, April 30th - May 6th 1999, p.9

Reports that North and East Devon Health Authority is to appeal against a High Court ruling in favour of a severely disabled woman, Pamela Coughlan. She had refused to be moved from an NHS nursing home, which was being shut down by the Health Authority, into a private one where care would not have been provided free of charge. In December 1998 the High Court ruled in her favour and held that the Authority was obliged to continue funding her health needs.

(See also Guardian. Society, 12th May 1999, p.6-7; Health Service Journal, vol.109, May 20th 1999, 9-10p)

SCOTT CALLS FOR MINISTERS TO SUBSIDISE NEW STANDARDS IN PRIVATE CARE HOMES

S. Herbert
Community Care, no.1272, 1999, p.6-7

Reports response of Sheila Scott, chief executive of the National Care Homes Association, to the proposed national standards on residential and nursing home care. Scott argues that the government should fund the implementation of the proposed standards in the private sector, and finds it unacceptable that local authority homes would not be bound by the same regulations, but welcomes standards relating to improved training.

THE THIRD OPTION: THE ONE THE COMMISSION MISSED

A. Walker
Working with Older People, vol.3, April 1999, p.16-18

Argues that the report of the Royal Commission on Long Term Care neglected the affordable option of abolishing the means test completely, and with it artificial distinctions between personal care and domestic tasks and between personal care and health care. This approach would cost up to £3 billion extra per year but the required resources could be raised by a German-style state long term care insurance scheme.

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