500% Spending Gulf In ‘Postcode Lottery’ Free Care

SOME pensioners may be missing out on free care because councils are not all working to the same standards when dealing with the elderly.

A report into the Scottish Executive’s policy of free care for the elderly that is published today identifies huge discrepancies between local authorities.

Researchers from the Joseph Rowntree Foundation found a five-fold difference in spending on free personal care between two neighbouring councils. Argyll and Bute spent £8,000 per client on free personal care at home in 2004-5, compared with £1,500 a year in North Ayrshire.

Alison Bowes, one of the report’s authors, said such big variations could lead to serious problems, with some councils having to ration their resources to cover only the most frail because of the large amount they were spending per client.

Other local authorities might suffer from different problems by not providing enough to cover the needs of each client. Ms Bowes said there was a need for councils to be given clearer guidelines, setting out what should be spent and what should be provided for clients, to prevent such big discrepancies.

She also said it was in the interests of local authorities to have the elderly in residential homes, because councils’ liability was fixed for those in care homes but not for those looked after in their own homes.

The need for new guidelines was reinforced by June Niven, secretary of the Irvine Seniors Forum, who said: “I do not think the Scottish Executive has laid down the rules very clearly.”

This latest report concludes that the policy was generally working, but with wide variations. It updates a report published at the start of last year which indicated the cost of the flagship policy could triple inside 50 years.

Last week, government figures showed the cost of providing free personal care to 50,000 pensioners had risen by £90 million to £237 million.

The authorities exhibiting the biggest discrepancies, North Ayrshire and Argyll and Bute, are separated only by short stretches of water.

Today’s report states: “It is difficult to envisage what circumstances would lead to such huge differences in costs between local authorities carrying out the same legal duty across a range of clients who do not differ substantively in their needs or condition.”

Argyll and Bute Council was at the centre of a row late last year when Professor Alice Brown, the public services ombudsman, said it should provide four months of back payments to a 90-year-old man who had been denied the service through funding problems. It pledged to fight the judgment.

It emerged in Prof Brown’s investigation that the council had been forced to freeze social-service spending as a result of its spending on free personal care and other consequent financial pressures.

Professor David Bell, another of the co-authors of today’s report, welcomed the announcement by the SNP government of an independent review of the policy, headed by one of its architects, Lord Sutherland, and said the funding issue had to be addressed.

“Firstly, there needs to be transparency about entitlements, with local authorities being clear on how they fulfil their responsibilities,” he said. “Secondly, the funding of the policy needs to be adequate to prevent any ‘rationing’ or reduction of services offered.”

• MIMA Morton, 74, lives in Bourtree Hill in North Ayrshire and has been getting free personal care since September last year.

She has assistance from two women, who help her to bathe, take medication and get into bed every day. She is also taken into Ayrshire Central Hospital in Irvine once a week.

As far as Mrs Morton is concerned, free personal care in North Ayrshire has been a success.

She said: “It’s really working well for me. The two ladies I have got who come to me are really the best.”

Mrs Morton is also helped out by a volunteer drop-in centre at Bourtree Hill, run by Age Concern.

The centre is staffed mostly by pensioners, who cook for those who come in and provide activities five days a week.

Mrs Morton said a combination of the free personal care service and the drop-in centre, run by Betty Weir, kept her looked after very well.

One 79-year-old woman in Dunoon, Argyll and Bute, who did not want to be named, said free care was vital for her because she could not do anything on her own. The woman, who is confined to a wheelchair, said the help allowed her to stay in her own home, which was very important.

She said: “I require two carers in the morning to hoist me up, to wash and dress me and hoist me into my chair.”

The woman said she was concerned because there were suggestions that she might have to start paying for meals. “The leaflet when the policy came in said we wouldn’t have to pay for meals if we couldn’t make them ourselves, and I can’t, so that is a worry.”

The provision of free care for the elderly in both these areas has come under the spotlight because North Ayrshire provides only £1,500 per year for every client living in their own home, compared with £8,000 per client in nearby Argyll and Bute.

Bernadette Docherty, from North Ayrshire Council, had not seen the report in full but said: “In North Ayrshire, we implement, in full, the Scottish Executive guidelines on free personal care, including the rates of payment.”