The politics of diversion in the great care funding debate

Topics covered: Ridouts professional advice

Over the past few days two news stories have dominated headlines in the care funding crisis debate. One centred on the Government seeking to place an obligation on the NHS to force foreign patients to pay upfront for NHS care. The other was the story of Iris Sibley, an elderly lady forced to remain in a hospital bed for six months due to the inability to find her an adequate placement within a nursing home.

Taking them both in turn the first idea to charge and seek reimbursement from foreign users of the NHS appears to be a diversion from the significant funding issues faced by the NHS. To seek to recover these monies that are unpaid the amount that could be recovered ranges from 200-500m annually. This is merely a drop in the ocean when compared to the often quoted 10bn that the NHS may find itself indebted by the year 2020. The ambition to recover a larger proportion of fees from foreign patients will hardly form part of the solution to the funding crisis that besets the NHS. It appears to be a policy which flatters to deceive and diverts the discourse about the deficit away from the very real problems that the NHS faces in meeting its financial obligations.

The second story relates to an incident of bed blocking on an almost unprecedented level. Six months within a hospital bed without recourse to a home is simply unacceptable. However the story, upsetting as it is, fails to consider the issues which may have led to this unacceptable wait for a placement. What would be helpful is to see behind the negotiations that occurred in attempting to place Iris within a nursing home place. It is highly likely that the placement would have been fully funded under continuing healthcare by the NHS.  One might speculate that such negotiations were protracted and may have seen placements that were available for her to move to but which were rejected by commissioners owing to cost. The fallacy of the costs argument lies in the fact that the cost of the placement for six months in the hospital cost £90,000 to the NHS which may have been considerably more than if she had been placed.

Stories that emanate from the NHS on a daily basis seem to reflect the observation that the NHS is under crisis. Stories such as the first which allude to a ‘protectionist’ policy position advanced by the Government do little to help the situation that the NHS is in. Arguably they highlight the Government’s inability to properly address the funding crisis that besets every area of the NHS right through the health and social care system. Stories such as Iris’ are a reminder of the real lives that are affected by the inaction of the Government to address the issue that flows from a lack of joining up care between the NHS and social care. The inability to place Iris for such a long period of time could only be as a direct correlation from the NHS being unable to pay for the cost of care at the required level.

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