Letter: Defining the limits of NHS care for the aged

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Sir: Nicholas Timmins ('Insecurely into old age', 15 August) suggests that Labour's reaction to the new guidelines on care for the elderly was 'muted' in its condemnation of the Government's broken promises. I certainly did condemn and would condemn the erosion of a seamless National Health Service implicit in the new guidelines, but such condemnation by itself would not be a sufficient response from a party that expects to be in government in two years' time.

As Mr Timmins points out, nobody has a 'simple solution' to the challenge of an ageing population, but it is not good enough to leave such a serious issue to a set of draft guidelines, amounting to a few pages of text, issued on a Friday in the middle of August by a junior health minister. And it was disingenuous of John Bowis (Letters, 15 August) to say that his guidelines were merely

confirming the judgement of the Health Commissioner in the Leeds case that the NHS continues to have responsibility for people's needs 'from the cradle to the grave' and that such treatments will continue to be free.

The existing guidelines state:

No National Health Service patient should be placed in a private, nursing or residential care home against his or her wishes or if that means that he or she or a relative will be personally responsible for the home charges.

But the new guidelines say:

However, where a person has been assessed as not requiring long-term care arranged by the NHS and refuses other options for long-term care, the health authority and hospital will need to take account of the needs of other patients in determining how long the person can continue to occupy an NHS bed.

Mr Timmins is absolutely right to see the change implicit between both sets of guidelines as an erosion of the 'cradle to grave' NHS, since the element of patient choice has disappeared.

A Royal Commission on the provision of long-term care could bring together a wide range of expertise and opinion to develop a national consensus on what level of care we expect to be provided for those with long-term needs and how that care might be resourced.

I believe that we should do all we can to ensure that such care is provided as part of the 'cradle to grave' health service, but simply stating that belief will not solve one of the most important social questions facing our nation as we approach the new century.

Yours sincerely,


MP for Sheffield Brightside (Lab)

House of Commons

London, SW1

15 August

The writer is Opposition spokesman for health.