Pledge to pay back wrongly charged care costs

The Scottish government has pledged to refund anyone being wrongly charged for care which should have been free.

It comes after BBC Scotland revealed people may be spending thousands of pounds on nursing home care which should be paid for by the NHS.

This can happen with people suffering severe stroke, or with Dementia, Parkinson’s and Motor Neurone Disease.

Health Secretary Alex Neil said every case would be examined where someone felt they should not have been paying.

Opposition parties called on the government to establish how many people may have been affected.

BBC Scotland health correspondent Eleanor Bradford reported that the number of people being awarded funding for nursing care in Scotland was falling.

If someone has severe health problems which require intense or complex nursing care then the NHS is obliged to pay for that care, even if it is delivered in a nursing home or in the person’s own home.

While Scotland does provide personal care for free, people in care homes and nursing homes are still charged accommodation costs.

It is this “hotel bill” which the NHS is obliged to pay for people who need nursing care as well as social care.

An Ombudsman decision in 2003 firmly established this principle in England, and thousands of individuals were able to claim back care costs they had been wrongly charged.

Since that landmark ruling, the number of “continuing healthcare” funding packages has been steadily rising in England. However, the number of people qualifying for continuing healthcare in Scotland has fallen by 26% in the four years since monitoring began.
‘Properly investigated’

Mr Neil urged those who felt they had been wrongly turned down for a continuing healthcare package to contact him and he would ensure the situation was “properly investigated”.

He told BBC Radio Scotland’s Good Morning Scotland programme: “The last thing I want to do as the health secretary is see people who are so seriously ill being denied the payment or the care they are entitled to. Where there is evidence, we will tackle that situation.”

Mr Neil insisted: “If there is anyone, or anyone’s carer or family, who feels they should have been receiving this payment and either haven’t been told about it or aren’t receiving it, please let us know because we will look at the case, case-by-case, and those who are entitled to it who haven’t been getting it will be appropriately reimbursed.”

The health secretary said he believed only a small number of people would have been missing out, adding: “The issue of whether somebody gets this payment or not is based on very clear, clinical criteria.

“Clearly there are a number of people, I think it’s a small number, but there are obviously a number of people who feel they have been wrongly turned down for this support.

“If they feel that they have been wrongly turned down then let me know. I will have it properly investigated and if they are entitled to the payment they will get the payment.”

The minister said that people should contact the chief executive of their health board and if they were still dissatisfied to contact him.

Numbers call

Scottish Labour health spokeswoman Jackie Baillie said: “There needs to be delivery behind the SNP’s rhetoric about improving access to care, but we also need some honesty about how it should be funded so that people in need benefit from clear and sustained levels of support.”

The Scottish Liberal Democrat also called for “immediate clarity” on the issue.

Lib Dem health spokesman Jim Hume said: “The health secretary must explain why the number of people being awarded funding for nursing care is decreasing when our population is living for longer and spending more years in ill health.”

Scottish Conservative leader Ruth Davidson said: “This first minister has a responsibility to find out how many people in Scotland caring for critically ill relatives have been handing over thousands of pounds when they shouldn’t have been – we need a full audit of every person in every health board who may be affected, either currently or historically, in order to ensure proper reparations are paid.”

Mr Salmond said people were assessed within the system at the moment.

He added: “What needs to be done and will be done – and certainly will be done – is that we’ll ensure that the regulations are properly followed.”

Mr Salmond stressed that there were opportunities for patients and their relatives to come forward.

“If there’s anything that has been done contrary to these regulations then it will be rectified,” he added.

Severely disabled

In one case, Robert Fyans asked for his mother to be assessed for continuing healthcare funding after a stroke left her severely brain damaged, but his request was refused.

The family were forced to sell their mother’s flat in order to pay her care home costs. As there is no independent appeals process in Scotland, the Fyans family felt they could not challenge the decision.

Parkinsons UK, Alzheimer Scotland, the Stroke Association and MND Scotland have all told the BBC they have concerns about the implementation of continuing healthcare in Scotland.

The Stroke Association is now calling for every stroke survivor to receive an assessment of their needs.

Interim director in Scotland, Elspeth Molony, said: “Some of the most severely disabled stroke survivors will also be eligible to receive a continuing care package which covers all their care costs from accommodation to personal and nursing care.

“However, not everyone entitled to this support is currently receiving it, meaning that many of the most severely disabled survivors are left struggling to cope with the after effects of stroke alone. This needs to change.”

What to do if you believe you are being wrongly charged

•     You are entitled to a ‘continuing healthcare’ assessment.
•     Remember this is separate to ‘free personal care’ and funding covers all care home costs.
•     If you are turned down, ask for a ‘second opinion’ – although this may not be not truly independent.
•     If you are still dissatisfied, complain to health board.
•     The Scottish Public Services Ombudsman investigates breaches in the process, not the eventual decision.
•     Check your household insurance to see if you are covered for legal expenses.