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Welfare Reform on the Web (March 2000): Care of the Elderly - UK

CITIZENSHIP AND SERVICES IN OLDER AGE: THE STRATEGIC ROLE OF VERY SHELTERED HOUSING

Beaconsfield: Housing 21, 1999

The needs and aspirations of older people are changing and they are looking for more flexible service models enabling more independence, choice and control over their lives. National policy also promotes more integrated services which provide independence for older people. Various forms of sheltered housing are seen as an alternative to residential care. Report examines the way in which very sheltered housing fits into this integrated response to older people's needs by housing, health and social services.

ELDERLY CHEATED OUT OF NHS CARE

A. Frean

Times, Dec. 2nd 1999, p. 2

A survey by the Royal College of Nursing shows that thousands of older people living in nursing homes are being made to pay for nursing care that should be provided free on the NHS. Almost 90% of health authorities were found to be using illegal criteria to decide whether or not elderly people in residential homes were entitled to free nursing care. Several authorities had decided that such basic nursing tasks as pain control and catheter care did not quality for NHS provision.

(See also Daily Telegraph, Dec. 2nd 1999, p. 6)

COMMUNITY CARE (DIRECT PAYMENTS) ACT 1996: DRAFT POLICY AND PRACTICE GUIDANCE

Department of Health

London: 1999

The main change proposed in this consultation document is to extend direct payments to people over 65, disabled children aged 16 and 17 and adults caring for disabled children. Using direct cash payments to purchase long-term residential care is excluded, so the most widespread application of the system for those over 65 is likely to be the purchase of domiciliary care.

CRISIS IN CARE

P. Saper and P. Champness

Health Review, Autumn 1999, p. 28-29

Argues that local authority purchasers have abused their position by keeping down fees and starving the independent care home industry of cash. Fee levels have, on average, hardly kept pace with inflation while costs, particularly payroll costs, have risen strongly.

HIGH AND DRY

J. Hirst

Community Care, no. 1300, 1999, p. 20-21

Care homes for the elderly are hitting deep financial trouble. This arises from a combination of inadequate fee levels paid by local authorities, rising payroll costs, increased government regulation and falling occupancy rates.

INHERITANCE TAX 'COULD FUND CARE'

N. Timmins

Financial Times, Nov. 12th 1999, p. 5

Reports proposal by the chair of the Royal Commission on Long Term Care that the government could increase inheritance tax to fund free personal care for the elderly.

MAKING IT HAPPEN; THE REPORT OF THE FIRST YEAR OF THE BETTER GOVERNMENT FOR OLDER PEOPLE PROGRAMME, 1998-1999

Wolverhampton: 1999

Describes a range of pilot projects which aim to improve public services for older people.

MINISTERS STUDY FREE NURSING CARE IN HOMES

N. Timmins

Financial Times, Dec. 3rd 1999, p. 4

Reports government moves towards making nursing care that requires technical competence to administer free in residential homes. Private insurance to cover the costs of long term care will be promoted, and the means test that currently requires people to sell their homes to contribute to the cost of long-term care will be re-examined. Long-term care standards will be regulated by a National Care Standards Commission to be set up by 2002.

(See also Independent, Dec. 3rd 1999, p. 8; Guardian, Dec. 3rd 1999, p. 12.)

OF PRIMARY IMPORTANCE: INSPECTION OF SOCIAL SERVICES DEPARTMENTS' LINKS WITH PRIMARY HEALTH SERVICES: OLDER PEOPLE

G. O'Hagan

London: Department of Health, 1999

Reports on an inspection, between August 1998 and March 1999, of social services departments' links with primary health services in eight authorities. Inspection examined the state and quality of joint working between social services and primary health services for older people following the 1993 community care reforms. Found that implementation of the 1993 community care reforms had generally not involved sufficient joint strategic and operational activity between SSDs and primary health services. Despite some valuable relatively small-scale exceptions, social services and primary health services mostly worked in parallel as two separate systems.

PEOPLE CAN PAY FOR THEIR OLDER AGE

D. Lipsey

Guardian, Dec. 2nd 1999, p. 22

Argues that the government should resist the temptation to win popularity by making long term care for the elderly free to all. This would benefit only the better off and open the flood gates of public expenditure. Proposes that the government should instead encourage people to take out private insurance, make the current means test on people who need long term care less onerous so that none need lose their homes, and invest in improving services.

VAT ON AGENCY HOME CARE STAFF

Anon

Registered Homes and Services, vol. 4, 1999, p. 98

There is growing controversy over the government's proposals to change the regulations regarding the conduct of the private recruitment industry, which have major implications for VAT paid on the wages of agency home care staff. In essence, if a purchaser of services uses a bureau or agency supplying care staff, the purchaser will have to pay VAT on the full cost. A local authority purchasing such a service can reclaim the VAT, but a private individual cannot.

WHEN WE ARE VERY OLD: REFLECTIONS ON TREATMENT, CARE AND SUPPORT OF OLDER PEOPLE

L. Easterbrook

London: King's Fund, 1999

Report drawn from two seminars attended by frontline practitioners and others working in health, housing and social care in 1999. From these discussions a number of key messages emerged: staff working in services are very critical of some aspects off provision for older people; there are major concerns about provision for the future; staff have a great number of ideas for improving services; there is not overall national vision shaping the system of support for older people.

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