Scotland politics

Alex Neil makes patient charges pledge

Generic image of a pensioner
Image caption Alex Neil said there would be no change for care home residents until new guidance has been consulted on

No patients will suffer financial loss as a result of implementing the recommendations contained in a review of long-term care, according to Health Secretary Alex Neil.

He was making a statement to Holyrood on the future of care services.

It followed the publication of a review into long-term care of chronically-ill people.

Labour claimed the report was "flawed" and could even mean "the NHS will no longer be free at the point of need".

But Mr Neil described the allegation as "pure nonsense" and said there would be no charges for primary healthcare. He has announced a consultation into the new care standards.

The health secretary made a statement to MSPs on plans to identify what additional support may be needed for specialist intermediate care services, which help people get out of hospital sooner and prevent unnecessary admissions.

The statement followed a review of the long-term care of chronically-ill people led by Ian Anderson, former president of the Royal College of Physicians and Surgeons of Glasgow.

The Scottish government ordered the review after concerns that people in Scotland who should have been eligible for free care were being charged care home fees.

'Continuing care'

The review said that continuing care, a fully-funded package arranged by the health service where someone has been assessed as having unpredictable and very high level clinical care needs, should be completely revised and renamed "hospital-based complex clinical care".

Mr Neil told the Scottish Parliament: "Patients being treated as part of the proposed continuing care programme will only remain in hospital for as long as that is clinically necessary.

"Any patient who does not require care in a hospital setting will be discharged from hospital into the community."

He said any policy changes would only come into effect when new guidance is consulted upon and developed in April 2015, and that current guidance would remain in place until then.

"Any patient who is currently in receipt of continuing care in a care home, or who is assessed as requiring continuing care before new guidance has been put in place, will continue to receive the same level of financial support as they would do today," he said.

"No patient will suffer financial loss resulting from the implementation of Dr Anderson's recommendations."

'Perverse incentive'

Labour MSP Neil Findlay attacked the report's recommendation that chronically ill people in Scotland should not have their care home costs paid by the NHS, and only those who have to live in hospital should be exempt from accommodation charges.

"Families are facing the perverse incentive of trying to make sure their loved ones stay in hospital to avoid crippling personal charges," he said.

"The recommendations in this report are a fundamental breach of the guiding principle of the NHS - that is an NHS that is free at the point of need.

"It is a flawed report, and having taken advice, I believe the proposals may be illegal."

Conservative MSP Jackson Carlaw said: "I do think there has been an ambiguity in public understanding of the recommendations arising in relation to continuing care."

He urged the health secretary to "correct that ambiguity in the public mind".

Mr Neil insisted there was "no intention" to charge for primary healthcare needs.

"People living in a nursing home, at home and in hospital have any healthcare needs met free of charge, in addition to their free nursing and personal care," he said.


In his statement, Mr Neil outlined proposals including:

•a consultation on the regulations for joint working across health and social care

•a consultation on national care standards

•a review of the methods used to inspect care with a focus on how well services are respecting the rights of patients

•joint work with local government body Cosla and health boards on residential care and supported housing

•an examination of services for people under 65 with complex care needs

•encouraging the sector to guarantee social care workers the living wage, including consideration of statutory guidance.

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