FAIRER CHARGING FOR HOME CARE IN ENFIELD

PROGRESS REPORT - January 3 2005

By Brian Wright


Enfield Council have revised their charging policy, the result of which is that more people have free home care or pay less than previously while about 14% pay considerably more in order that the Council can balance its books. One of the problems is that government guidelines gave councils a fairly free hand as to how they assessed their charges and we now have what has been aptly described as a postcode lottery.

In assessing the charges all clients are means tested and two elements are considered

The client's contribution is either

(i) a percentage of their net disposable income (NDI) less certain allowances. (This actual calculation is complicated and if anyone requires full details I shall be glad to explain) or

(ii) the cost per hour of the service provided.

Clients are required to pay the lesser of these two amounts.

Enfield Council charges are 100% of NDI or £13.65 per hour. Anyone who has savings of £20,000 or more will pay the full charge. Enfield's hourly charge is higher than that imposed by any of the other North London Boroughs and it is the only one that does not have a maximum weekly charge - resulting in one client paying £664 per week.

Council Working Party on Fairer Care Charging

I have been representing the Forum on a Council Working Party, which meets monthly with Council representatives to discuss fairer charging. Many points have been raised and the following are probably the most relevant:

Council Officers have advised that they have nearly 1900 clients of which 11 percent are paying the full cost of this service and 48.7% are in receipt of free home care services.

In house services are more costly than contracted out services although thought to provide better value.

Working groups are attended by councillors who have advised that a number of complaints have been received about miscalculations and high charges. There is concern that vulnerable people may decide not to continue with home care services or go private.

In the year April03 to March04 there have been 110 appeals all but 8 of which have been resolved. In the current year to the end of September there have been 58 appeals 10 of which am still outstanding.

 The Council is aware that their charges are high compared to other boroughs. I have strongly urged them to revise their charges to come into in line with the average charged by other boroughs and to set a reasonable maximum weekly charge. Under the Health and Social Care Acts the NHS is obliged to provide funding for continuing health care needs and there Is judicial precedent for this in the "Coughlan" case. It is of considerable concern that clients might be charged for services, which should be paid for by the NHS. Further meetings are planned and the Forum and other voluntary groups in Enfield will do their best to persuade the Council to address their many concerns. The Groups include representatives from Age Concern, Enfield Disability Action, Enfield Asian Welfare and the Alzeihmer’s Society — a force to be reckoned with!

There will be a public forum for service users and their carers on Monday 31st January 20O5 at Saint George’s Parish Hall, 710 Hertford Road EN3 6NR at 12noon until 2.30pm. Any Member with immediate concerns or wishing to attend the meeting should contact Natalie Cole, Democratic Services Team, 3rd Floor, Civic Centre, Silver Street, EN1 3XA. Tel: 020 8379. 4088.

In the final analysis the Forum will endeavour to ensure that principle of fairness will not be overthrown in a desire to balance the books, particularly as one Authority, the London Borough of Camden, provides this service for no charge.

Brian Wright. January 2005