27 January 2006
A High Court judge has ruled that the criteria used by many primary care trusts to assess whether someone should have to pay for their nursing care are 'fatally flawed' in law.
The ruling has 'wide implications for a number of individuals, strategic health authorities and the NHS', Tim Ward, a barrister for the Department of Health, said after the judgment on January 25. The DoH is considering an appeal.
The family of Maureen Grogan brought the case against Bexley Care Trust after it refused to pay for the cost of her substantial health needs on the basis that she failed to meet the criteria laid out in its 'continuing NHS care' assessment.
Grogan did, however, meet the criteria for the trust's separate 'registered nursing care contribution', and thus had part of her clinical nursing care funded.
But Justice Charles ruled that the two categories were indistinguishable: if Grogan qualified for high-band nursing care, her health care needs should be deemed her 'primary' need. Therefore she should automatically qualify by law for free 'continuing NHS care'.
The judge said that while the case had been brought and found against Bexley, the trust itself had been 'led astray' by the DoH. He endorsed recent calls from the Commons health select committee and the health ombudsman for the DoH to issue a single, nationwide set of guidance.
'It seems to me important that the department do this, rather than leaving matters in the hands of care trusts and local authorities, not least to promote a consistency of approach,' he said.
The case, he added, raised 'important and widespread issues of public importance and interest' which 'can have a profound effect on the individual concerned'.
Liberal Democrat MP Paul Burstow, who sits on the health committee, told Public Finance: 'The judgment demonstrates that this government has connived and been part of a process over successive governments of redrawing the boundaries by stealth between what people have to pay for themselves in terms of care and what is free.
'What the court has done is say that it's not sufficient for the secretary of state to say it's just the PCT's fault, it's actually down to the underlying guidance that the department has been giving.'
PFjan2006
