The Care Bill: The road to more private medical assessment injustice?

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At a time when almost one million carers, older, disabled and sick people are not receiving the care and support they need, the Care Bill is currently meandering its way through the chambers of Westminster. It is described as:

“A Bill to reform the law relating to care and support for adults and the law relating to support for carers, to make provision about safeguarding adults from abuse or neglect, to make provision about care standards, to establish and make provision about Health Education England, to establish and make provision about the Health Research Authority, and for connected purposes.”

The aims of the bill are:

  • Create a cap on care costs.
  • Extend the current means test threshold for financial assistance.
  • Ensure nobody has to sell their home in their lifetime to pay for residential care.
  • It will merge sixty years of care and support law into a single Act, which according to the government will be “built around the person not the service”.
  • Enshrine in law the right for carers in England to receive support from their local council.
  • Ensure that people requiring care can be moved between local authority areas without fear that their care will be interrupted.
  • Provide a new legal entitlement for everyone to a personal budget , which they can opt to receive as a direct payment to give them more control where desired.
  • Clarify in law what protection will be put in place to ensure care is not disrupted if a care provider goes out of businesses.
  • Establish Health Education England and the Health Research Authority as non-departmental public bodies, to give them the independence to carry out their roles.

    With the principle of introducing a capped cost social care partnership model set out in the Care Bill, the next step will be to resolve the Pandora’s box of issues that need to be resolved in time for April 2016. From then on, people’s qualifying social care costs could count towards reaching the cap of £72,000, after which the state will help towards the cost of the person’s care.

    The heads of 38 leading charities including Age UK, the Alzheimer’s Society, Scope and the British Red Cross, have sent a letter to the Prime Minister warning that a change in how needs are assessed could strip 135,000 frail and vulnerable people in England of state-funded care on which they currently rely.

    The charities have warned David Cameron that almost 900,000, who already have to pay if they want help with basic tasks such as washing and dressing, would not be able to benefit from a cap on the cost of care.

    They say that the Care and Support Bill, which will usher in a cap on the cost of care to prevent people being forced to sell homes, should transform the system for future generations. But they add that they are now “seriously concerned” that when the final details of how the system is to be implemented are worked out, huge numbers of frail, elderly people will still be left without any help with their care.

    Under the current system, only elderly people with assets, including their family home, worth less than £23,500 get help with the cost of care. Even then, only those deemed to have the greatest physical needs qualify.

    Those are assessed on a four-point scale ranging from “low” to “critical” with just people above a threshold — decided by local social services – getting help.

    In recent years, with funds squeezed, councils have tightened up criteria, meaning that in most areas only those deemed to have “substantial” needs qualify — usually meaning they can no longer live on their own.

    Another area of major concern is a part of the Bill introducing a national assessment framework to assess people’s eligibility for care, and also to have the associated costs count towards the cap. This gives local authorities the power to contract out the assessment process of people – to determine how bad their care needs are and what services they might need.

    Over the last few years we have seen similar processes adopted via Work Capability Assessments (WCA) of the disabled and sick with contracts awarded to companies such as Atos. If you are aware of these assessments, no doubt, you will also be aware of the hundreds of accounts of people who are clearly unable to work due to health problems being declared “fit for work”.

    Even if we are to take the giant leap of ignorance and put aside the obvious injustice and persecution of a section of our society, the use of companies like Atos being used to assess the needs of care are extremely concerning:

    Dr Greg Wood, a former Royal Navy doctor, resigned from Atos in May after working as an assessor for the company for two-and-a-half years. He said said the system was “skewered against the claimant”. He also stated that a number of the tests were staged in such a way as to find people fit for work and an excuse cutting their benefits.

    Last year Atos – which in total earns £1.6billion in Government contracts –  ‘won’ a government contact, worth £184 million, for London and the South of England on the promise of a tender stating that it had a network of 740 assessment sites across this area. However the Department of Work and Pensions (DWP) has now admitted that Atos only has “up to” 108 centres available that meet its requirements.

    The boss of Atos, Thierry Breton, has been awarded a £280,000 pay rise after his firm helped to heap misery on thousands of disabled people who are deemed fit for work. His total package of pay, bonuses and perks is now £2,329,250. For the same period in 2011, Breton received £2,049,250.

    The parent company of Atos is American based “Unum Provident”, a company that makes its cash selling sickness insurance policies. Their “medicals” have been declared illegal in the states and branded “disability denial factories”.

    Part of the WCA process is that people are allowed to seek advice and take another person with them to the interview. However there have been numerous accounts that this right is often challenged or refused at Atos centres. At an assessment centre in Liverpool recently, Atos staff called the police to remove a demonstration that was “threatening and upsetting people”. It subsequently transpired the ‘demonstration’ consisted of 2 Councillors handing out leaflets giving advice to people attending assessments and the Atos staff also refused to carry out an assessment after a person being assessed requested one of the ‘demonstrators’ to attend the ‘medical’ with them.

    We all need to ask ourselves, would we entrust the determination of our own care needs, or those of our parents, to companies such as Atos? And at the same time we must remind ourselves, and make everyone aware, that hundreds of thousands of disabled and sick people have already had this inflicted upon them and suffered the utter despair and injustice that goes with it.

Kevin Smith

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