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Long-term care

Who will foot the bill?


Long-term care is one of the less palatable realities of life. It can lead to high costs payable to a care home and, for many people, it has to be funded by themselves.

There are two basic levels of care for those unable to look after themselves: residential homes and care homes with nursing. The average residential care home in the UK costs from £400 to £500 a week. But if nursing is required, weekly costs can range from £550 to £1,200 a week. It is not surprising, therefore, that an estimated 70,000 homes are being sold each year by families to pay for a relative’s care home fees.

In Scotland, personal care is paid for by the state, but in England the funding system requires NHS trusts to decide whether an individual needs medical or social care. If the need is medical, the NHS will foot the bill.

However, if the primary needs are personal, such as assistance with dressing, the case goes to the social services for means testing. Anyone with assets over £21,000, including their home, must meet all the costs for care themselves.

Problems have arisen when the care trusts interpret the distinction between medical and personal needs differently. This has given rise to a postcode lottery where the same condition could merit different treatment in different parts of the country.

In June 2006, the Government sent draft guidelines to health authorities, the first such attempt to provide a national standard on who is eligible for funding. The consultation period on the draft closed on 22 September 2006 and the Government is considering the responses before it publishes the final guidelines.

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