The £180 million overcharging bill

The BBC reports that the NHS has spent £180 million compensating patients wrongly charged for long-term care:

"Patients charged for long-term nursing and social care from 1996 to 2004 have been able to have their cases reviewed if they feel they were overcharged. This has led to over 13,000 claims and 2,000 pay-outs, costing £180m. The claims relate to the way different health authorities charged for care needed because of illness, disability and continuing NHS treatment.

This "continuing care" used to be effectively classed as social care and as such was means-tested. But a legal challenge in the 1990s led to health bosses being told to fund care packages where the primary need was health, rather than just basic personal care such as helping dressing and washing. However, the rules were interpreted differently across the country. This proved particularly controversial and stories emerged of patients having to sell their homes to fund care - hence the high figure for the pay-outs."

This failure to properly understand what a health authority is expected to deliver is a failure of management.  Managers in the NHS, many of them very well paid, should be able to establish the specifications for their service.


Failure to meet standards for care provision has proven expensive for the taxpayer.  Reviews and compensation proceedings are rarely cheap so not providing care in the first place won't have saved money.  It has also dealt a particularly telling blow to vulnerable people forced to sell their homes or make other sacrifices that they should not have had to make:

"And a spokeswoman for the Alzheimer's Society added: "The charging for care caused a lot of heartache. People had to sell their homes and go into debt. "

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