Pamela Coughlan needs day to day care

She had been living in an NHS nursing home, receiving free NHS care, but the health authority decided to close the home and move her to a local authority residential home.

She faced losing her entitlement to free NHS care, and being means-tested and charged for accommodation and personal care provided by social services.

The court ruled that Mrs Coughlan was entitled to free NHS care - but not to free personal care. It said the NHS should pick up the tab for the medical nursing care.

This was a mixed result for campaigners, as it decided that the NHS was allowed to shut nursing homes and shift responsibility for care to local authorities.

Then Health Secretary Frank Dobson welcomed the verdict, which applied only in England and Wales.

The NHS Plan

The government's "design" for the future of the NHS was published in July 2000, and included its response to the Royal Commission's recommendations.

To the deep disappointment of pressure groups, it decided to implement it, but only partly.

Alan Milburn: Fully free care "too expensive"

From October 2001, the plan said, the NHS component of care would become free for all.

"People should not be asked to contribute towards the costs of their nursing care," it said.

However, it said that making all personal care free was unfeasible.

"Actioning the proposal would absorb huge and increasing sums of money without using any of it to increase the range and quality of care available to older people."

Scottish U-turn

Labour's plans for partial funding of long-term care in England were made to look less than generous by the Labour administration in Scotland, which succumbed to a backbench revolt on the issue in January 2001.

In future, both personal and medical care in Scotland will be funded by the state, giving ministers a financial headache - and campaigners south of the border a lever with which to apply pressure for free care across the board.