Financing long term care for those suffering with Alzheimers
Our increased longevity is bringing many problems such as the difficulties over pension funding, additional health costs, changing housing needs and social support for those who are elderly. But the nightmare for many individuals and families is the prospect of no longer being able to look after oneself and needing residential or nursing care. There are very good care homes in Leeds North East but the cost of provision is high. Typically living in a care home may require an expenditure of up to £600.00 per week. If round the clock nursing cover is needed then weekly fees can be of the order of £750. Such charges are not met by the NHS. Normally they are paid by the person in care and in general for a single person, (a usual situation following the death of a partner), this means using up any savings and selling the home. Financial help is only available if the person's total assets are worth less than £23,000, when support from the local authority becomes available. This is an oversimplification as there are some allowances that may be claimed but they (certainly) do not add up to the sums of money needed. Many see the present system as unfairly penalising those who have saved money all their lives, paid all their taxes and health contributions and who often wish to leave it to their loved ones or charities.
Nowhere is the problem more acutely felt than by families having relatives with Alzheimer's disease. This distressing condition can reduce people to the level where they become unable to communicate in any way, totally dependent on others for dressing, eating, all personal hygiene and needing round-the-clock love and care simply to ensure their personal safety. Alzheimer's can strike relatively young people with many years to live and in these circumstances, care fees can become a financially crippling nightmare.
My attention has been drawn to this issue by Mr Adrian Fox, whose mother suffers from total dementia and who is being wonderfully looked after here in her home constituency at Donnisthorpe Hall. I am grateful to Adrian for his permission to talk about the case of his mother. We all hope we may grow old but pray that we will be able to look after ourselves. Alzheimer's is a disease that can strike us down, there is no cure and it seems wrong that all our taxes paid into the Treasury for the health service cannot meet the necessary costs of care if we become so very ill. Primary Care Trusts, local custodians of health budgets, make the decisions that affect us all - including the post-code-lottery cases over issues such as funding expensive drug treatments or, in this case, whether a person very ill with dementia should be looked after by the NHS. Adrian, who has been fighting for financial support for his mother contacted me as he felt that the Leeds Primary Care Trust was treating her case unfairly arguing that since his mother showed no signs of distress, notwithstanding that being impossible to totally assess, she did not need or justify continuing nursing care. I am always concerned if I feel that state institutions do not treat people fairly and asked that Mrs Fox's case be reviewed. At the same time Adrian brought the public's attention to the matter through a feature article written by the Yorkshire Post (Click here). Coincidently there has also been a recent judgement made by the Health Service Ombudsman concerning an Alzheimer suffer in Worcestershire that required the local health authority to meet the charges that had been incurred for continuing nursing care. For Mrs Fox there has been a sudden change of mind by the Leeds Primary Care trust who will now be meeting her continuing care charges. There can never be a happy ending in such cases, Mrs Fox will never get better, but she is now receiving financial support after being a tax payer for many years.
We need a solution to the problem of paying for residential care of the elderly. The money will have to come from all of us, the question is how. The Parliament of Scotland decided that charges in that country would be met by their government but they have experienced great budget difficulties and there are still problems. If the NHS budget is to be sufficient it will need a significant extra stream of income but would there be a political consensus to increase National Insurance charges accordingly? Should the costs be met by requiring people to work longer and further raising the retirement age? It has been suggested that there might be an indemnity scheme - an up front payment of say £20,000 - made while fit, to be entitled to free care later. But is this fair when many people would be genuinely unable to pay this - and so what happens to them when they grow old and infirm? Should the costs be funded for the well off through additional death duties which would at least leave a substantial proportion of an estate for legacies? Could the payment of care charges be offset against death duties? Some detailed actuarial studies are needed urgently for we must have some policy in this area. Concern is growing and I believe the major political parties should have clear policy for their election manifestos. In the remaining term of this parliament I shall lobby my Labour colleagues for action to this end.
In the meantime, to any constituents reading this who are specially concerned, please do contact me if you feel I can help you. Study the case that the Ombudsman resolved at http://www.timesonline.co.uk/tol/life_and_style/health/article6801229.ece and use this as a precedent. I shall always remember Mrs Fox who has brought home to me the injustice of the present system.
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