Half of all Labour MP's say that free nursing care is not working

Paul Burstow MP, Liberal Democrat Spokesman for Older People, today revealed that 165 Labour Members of Parliament have written to the Department of Health to complain about the Government's so called 'free' nursing care scheme for older people in care homes in England.

The details were revealed in a Parliamentary answer to Mr Burstow which shows that 52% of all Labour MPs in England have now written to express their disgust. Members of Parliament registered their concern on a number of issues relating to so-called 'free' nursing care including fee levels; the process of assessment; banding levels for registered nursing care contributions; policy justifications; the mechanisms of payment and the costs of equipment.

Paul Burstow MP said:

"There is something seriously wrong when Labour MPs are writing to the Department of Health to express deep misgivings about a policy introduced by their Ministers. Even Labour MPs now know that so-called free nursing care is unfair and unworkable.

"Health Ministers are lone voices in the wilderness of public opinion. They are burying their heads in the sand and ignoring the calls of their own party to scrap this farcical system.

"The 'free' nursing care policy is a sham. It is a scandal that despite all the evidence of failure, Ministers persist with this ludicrous and deeply unjust policy. It is now time that the Government adopted the recommendations in the Royal Commission for Long Term Care and implement free personal care."

ENDS

Notes to Editors.

There are 529 English constituencies affected by 'free' nursing care in England. Labour holds 323 of these seats, with 165 having written to the Government.

The information was revealed in the following Parliamentary answer to Mr Burstow: -

Care Homes

Mr. Burstow: To ask the Secretary of State for Health how many representations he has received on the member failures of care homes to pass on 'free' nursing care contributions to residents from (a) Members of Parliament by party group and (b) members of the public. [82965]

Jacqui Smith [holding answer 25 November 2002]: Of the in excess of 20,073 letters received by the Department from hon. Members and the in excess of 31,278 received from the public in the last 12 months; 332 and 301 covered issues relating to free nursing care, including fee levels, the process of assessment, banding levels for registered nursing care contributions, policy justification, the mechanisms of payment and the costs of equipment, broken down by party group as follows:

Labour-165

Conservatives-126

Liberal Democrats-36

• Free personal care in Scotland was implemented on the 1st July 2002

• In April 2002, Mr Burstow published the report "Putting the 'Fee' into 'Free' Nursing Care". The summary and recommendations can be seen below: -

2.1 Despite the best endeavours of the coordinators and lead nurses, the 'free' nursing care scheme is a shambles. The results of the survey show that for thousands of people 'free' nursing care has proved little more than a cruel hoax.

2.2 By Christmas 2001, all 42,700 self-funders were supposed to have been placed in a nursing care band, but Ministers failed to issue the final guidance for the scheme until five working days before it was due to begin. As a result there are as many as 5,124 people waiting to learn which band they are in. On top of that, there are 3,206 people who are awaiting nursing care payments. As many as 1 in 5 people eligible for 'free' nursing care were waiting for a reduction in their fees. This amounts to £11.9 million in outstanding payments.

2.3 Despite warnings from the multi-agency group advising the Department of Health on the implementation of 'free' nursing care, Ministers pressed ahead with payment via nursing homes, and rejected calls for direct payments to residents. As a result, 6 out 10 co-ordinators report evidence of nursing homes failing to pass on payments in the form of fee reductions. In practice homes have increased their fees to match the payment for nursing care. For many residents 'free' nursing care has become a zero sum gain as the nursing home simply puts up the gross fees to match their nursing care banding.

2.4 The Government should not scapegoat nursing homes for its own failure to ensure the money got to those entitled to it. Liberal Democrats have been warning Ministers for at least the past three years of the pressures on the care home sector in general and on nursing homes in particular. Fee income for Local Authority funded residents has not kept pace with costs.

2.5 Because of the scale of the task and confusion about the way in which assessments are to be undertaken, as many as 5,636 (13%) people have had decisions about their nursing care taken without ever being seen by a nurse.

2.6 Ministers said that 800 nurses would be trained to undertake the determinations by Christmas. In order to deliver, Health Authorities and Primary Care Trusts have diverted as many as 1,500 nurses from front-line duties to undertake the banding assessments.

Recommendations

2.7 The Government should abandon the initiative and commit itself to implementing a scheme of free personal care along the lines recommended by the Royal Commission on Long Term Care.

2.8 During the transitional period the Department of Health should issue new guidance to Health Authorities and Primary Care Trusts, requiring them to make arrangements to report all irregularities to NHS Regional Offices, and make nursing care payments directly to nursing home residents.

2.9 The Government should commission an urgent review of care home capacity to inform the development of a national strategy and local action plans, to secure an adequate supply of beds. The review should examine the adequacy of fee levels, local labour market constraints and the costs associated with complying with the National Minimum Standards.

2.10 A further urgent assessment should be made of each of the 9,000 people in the high band for nursing care, to determine if any of them should be entitled to free continuing NHS care.

2.11 NHS Regional Offices should ensure that all outstanding payments and banding decisions are completed by the end of March. An assessment should be made of the loss incurred by nursing home residents, and compensation should be included with backdated payments.