Ground-breaking victory for Pam

The cost of long term care can run into thousands of pounds - but who should foot the bill ? Should you save for the costs of your own care, or should the State pay ?

Five years ago Pamela Coughlan won a ground-breaking court case against her local health authority who wanted her to pay for her own care privately -- they were stopped from pushing her out of an NHS care home which they wanted to close.

Suddenly it became clear that many elderly people or their families were paying for their own care when the NHS should have been footing the bill.

Complaints

But the solicitor who fought Pamela's case, Nicola Mackintosh, says she's still getting more complaints than she can cope with about the NHS not funding care which happens out of hospital.

She warns that each case is judged on its individual circumstances.

Nicola Mackintosh is still getting complaints

"Just because somebody needs help with feeding or with getting up out of a chair or going to the toilet that doesn't necessarily mean they're eligible for NHS funded care, because that can be deemed to be personal care, i.e. social care"

You could have to go through three tests to find out whether you have to pay for your care outside hospital.

Tests

First there's a care test. The NHS decides whether you need healthcare paid for by the NHS. If your main need is for accommodation then you'll need social care, which is overseen by your local authority social services.

There's then a means test. If you only qualify for social care anyone with less than �19,500 in savings will have all or part of their care paid for.

If you fail the means test, there's then a nursing test in England and Wales.

If part of your care is provided by a nurse, that element is paid for. In Scotland you'll find that more is covered.

Appeals about this are dealt with by the Health Service Ombudsman. They say they're dealing with over three thousand complaints from people who believe their care should have been paid for by the NHS.

There has recently been a significant decision in favour of an elderly gentlemen who received his care at home.

This case concerns Malcolm Pointon who suffers from Alzheimer's disease.

He's unable to do anything for himself and is cared for full time at home by his wife Barbara, at a heavy cost.

She had been offered NHS-funded care if he went into a hospital or a nursing home -- but after the ombudsman's ruling she will be paid �1,000 a week by the NHS to look after him where he is.

Missing out

Campaigners on this issue are angry that after so many years of trying to clear up the rules, people are still missing out.

Nicola Mackintosh says that over the last five years the government has consistently flouted the law. "I find it incredible that despite a clear judgement at the Court of Appeal health authorities around the country are implementing different criteria for who should have access to health treatment and haven't been following the judgement in the Coughlan case."

The Department of Health issued the following statement:

"All Strategic Health Authorities have now agreed new criteria and are in the process of reviewing past cases and recompensing the cost of care wrongly denied, subject to a full investigation of the facts in each case...We are about to introduce a new requirement that means that before people leave hospital , the NHS is required to assess them for continuing care.