VIRGINIA Bottomley's announcement of a meagre £540m to local councils to implement the government's community reforms from next April will trigger six months of crisis and confusion.
The money - of which £140 million is a one-off payment for set-up costs - is just half the amount the councils and originally asked for.
The Tories are stipulating that 75 percent of the cash must be spent on purchasing care from private residential and nursing homes: à maximum of a quarter can be used to finance council-run services.
Assessment
This makes quite explicit a factor that until now had been overlooked or wilfully ignored by Labour and trade union leaders. Behind the rhetoric of 'community caré' - in theory caring for people in their own homes or small, friendly units rather than in big hospitals and institutions - the Tories have been embarked upon the biggest-ever exercise in privatising health care and imposing charUnder the new regulations, local councils are supposed to take over from health authorities the lead responsibility for continuing care of the frail elderly.
Care which was provided free at point of use in NHS beds and day centres is from next year to be subject to means-tested charges.
Councils and social services will take on the task of assessing the needs of frail elderly clients. They will be responsible for purchasing appropriate residential, nursing home or domiciliary services -but whatever the assessment, the client will have no right to any specific level of Cale.
Many councils, fearing government financial penalties, have begun closing or selling off their own homes for the elderly, while health authorities have been rushing to shut their geriatric beds in order to unload the problem (and expense) onto the councils.
The community care reforms will mean that even more elderly people, a generation who have paid taxes and National Insurance all their lives expecting comprehensive health care when they grow old, are to be forced to raid their savings or sell their homes to pay for their own Already forced sales of houses by elderly owners obliged to meet residential or nursing home fees are estimated by the Financial Times at over £2 billion a year -while the clients themselves are being The £2.5 billion a year in fees whic pay for care in residential and nur £2.8 billion market in private medi statistics on private health care. obliged to shell out a massive £2.5 billion a year in charges over and above their Social Security income support entitlements.
Elderly people coming into the new system after April (an estimated 110.000 in 1993-4) will have their entitlement to social security cancelled out by the new reforms.
Instead they can receive only discretionary support, administered by local councils which are themselves subject to
AGLE