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Disabled could be ‘forced out’
Care at home judged ‘too expensive’
DISABLED and elderly people could be forced to leave their homes under new cost-cutting care measures, campaigners fear.
Camden’s health authority is drawing up new budget rules which say that if care at home is too expensive then it may be refused – a measure which could force people to move into a hospice or residential home.
Campaigners argue the proposals from Camden Primary Care Trust (PCT) are putting moneysaving rather than patient need at the centre of care policy.
Patient groups have also criticised the PCT for not consulting affected groups on the changes although it will consult the trust’s own patient forum. The trust’s assistant director of strategic planning, Rebecca Harrington, who presented a report of the changes to the PCT board, said: “There will be no change to the service so therefore no need to consult.”
Presently Camden is responsible for 75 people, 19 of whom are cared for at home, but observers say, with an ageing population, this number is set to rise.
Cost is not considered when deciding where they should be cared for – at home, in a hospice, or in a residential home. But the new plans will “generally agree the most cost-effective placement”, giving a 10 per cent leeway should a patient contest the decision.
Ms Harrington’s report says care at home is “more expensive”, adding there is no law to stop the trust refusing home care if a “more cost-effective placement were available in a residential setting”.
If the policy is agreed, present arrangements will be reviewed, which could mean patients being forced to move to cheaper residential homes, or even forced out of Camden. Ms Harrington confirmed: “Most placements are out of borough, except for older people – where we use three nursing homes and St Pancras Hospital.”
One PCT insider accused the PCT of covering up its plans with “legal loopholes”, adding: “They should engage the public.”
Royal Free forum member Arthur Brill branded the board’s limited consultation, which only takes in the trust’s patient forum, “ludicrous”, adding: “I could see this going to judicial review.
“This should be interpreted as a major system change which needs transparency. I don’t think it’s fair for the PCT to put the onus on the forum, which is small and newly reformed. To call that consultation is ludicrous.”
Audit committee chairman David Metz questioned a clause banning patients or relatives “topping-up” care costs, suggesting it will be “a problematic area”.
One board member said: “The critical issue is why patients can’t top-up in terms of finances but can in terms of their own time. You can stay off work to do the care but you can’t go back to work and pay for a carer.”
Trust chairman John Carrier said he’d be interested to see if the issue was picked up by the patient forum.
Trust forum members Janet Albu and Neil Woodnick are calling on people affected to contact them, and will raise concerns with Ms Harrington next month.
Ms Harrington said: “We have no policy for determining how much choice a patient can exercise.
“As a PCT we’re required to balance choice with cost. We’ve taken legal advice. We’ll look at need, individual’s wishes and cost and choice will be possible within a banding of 10 per cent.”
The contingency care budget for 2006-2007 is £10,810,000 with a projected half-yearly overspend of £2 million. |
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