Letter: Policy on NHS charges unchanged

Sir: The draft guidance on continuing care issued by the Department of Health for consultation on Friday was not, as your report 'Cradle to grave NHS buried by Government' (13 August) suggests, abandoning any national guarantees for patients. Rather it was confirming the judgement of the Health Commissioner in the Leeds case that the National Health Service continues to have responsibility for people's medical needs 'from the cradle to the grave' and that such treatments will continue to be free. Local health authorities will decide how - and not whether - such needs should be met.

Once the medical needs of a patient have been confirmed by the doctors involved as having been met, then there has never, of course, been a right to stay on in a hospital bed, which will be needed by other patients. Most people go home after hospital: some need a period, short or long, in residential care. If this is judged by doctors to be a medical need, then it will be paid for by the NHS. If it is a social care need, then it will be arranged by social services, which will pay for those on low incomes and ask for a contribution towards the cost from those who can afford it.

If someone does not wish to be placed in a residential home where there will be a charge, then he or she will continue to have the right not to be placed there and, instead, social services will see if a package of home care can be agreed.

In other words, no change is proposed in charging policy, no change is proposed in the responsibility of the NHS for medical care. Better and more open planning of services and a better understanding of their respective responsibilities by health and social service authorities are what, through this guidance, we are seeking.

Yours faithfully,

JOHN BOWIS

Parliamentary Under-Secretary of State

Department of Health

London, SW1

13 August