This piece first appeared in Saga Magazine in September 2006
The text here may not be identical to the published text

 

Charges damage the NHS

 

National Wealth Service
T
he system of charging for various NHS services "is a mess" according to a powerful parliamentary committee, with many people exempt who could pay and others who are hard up getting no help. In a damning report the committee says that charges have a negative effect on health, and calls on the Government to examine the effect of abolishing all existing charges. When the NHS began there were no charges. But from 1952 prescriptions cost a shilling and dentists and opticians also began to impose charges. Today a prescription for adults under 60 costs a whacking £6.65 (£3 in Wales and set to be abolished there next April). But the report says barely one in eight prescriptions is paid for. If everyone paid a flat rate of £1 per item with no exemptions even for those over 60, it would bring in an extra £120 million. The MPs call on the Government to examine making the charge flat rate for all or scrapping it completely. Failing that, the MPs say the Government should at least review the list of illnesses that entitle people to free prescriptions. Since this list was drawn up in 1968 new diseases have been identified, others have become treatable. The result is that some people with long-term illnesses have to pay, while other conditions like insulin-dependent diabetes are exempt. The committee also criticised the charges for dental care and glasses. At present everyone has to pay – there is nothing free for the over-60s apart from an eye test. People on a low income with savings under £16,000 can get dental care and some spectacles free or at reduced cost, but the committee called for changes to the complex application form. One member said, "I am absolutely horrified. It is the most impossible form anyone could fill in." The NHS also raises money in other ways. More than 90% of hospitals in England charge for parking. In Wales the figure is about half but only one in 20 in Scotland. The average fee is £1.22 an hour but some charge up to £4. There are no concessions and parking can become very expensive if you have regular treatment or have a relative or friend in hospital for a long time. The committee wants new rules so that frequent visitors can buy season tickets and patients who have to visit regularly are exempt.

Yacht spotters
Forget the notebook and pencil on a wet railway platform. A growing number of people are swapping their anoraks for shorts and deck shoes as they go yacht spotting. They prefer the harbours of Monaco or San Francisco to Clapham Junction. A new breed of spotter is keeping records of where large yachts are and sharing their research on the internet at yachtspotter.com. It tracks "megayachts" – more than 100 feet (30 metres) long – through a network of spotters. Enthusiasts also track the changing names and refits of yachts but there is very little information about who owns them. And with some prices in the tens of millions that would be interesting.

Equity relief
Each year around 45,000 older people raise more than £1 billion by taking out a lifetime loan against the value of their home. It’s called ‘equity release’ and on average they raise £24,000 each. But what do they spend it on? Research by Norwich Union shows a remarkable consistency month by month over the last eight months. The insurer now asks everyone who borrows money against their home – nowadays called a lifetime mortgage – what they use the money for. Top of the list is repairing or improving their home with nearly three out of four using some of the money that way. Nearly four out of ten use part of it to go on holiday. Norwich Union says one customer used it for an annual visit to see a long lost brother – trips he could not otherwise have afforded. A fifth use some of the money to help grandchildren and others with the cost of university fees. Brendan Kearns, product development manager at Norwich Union, says that it takes nine to twelve months from thinking about equity release to actually taking what can seem a difficult step. "One of these reasons will trigger the desire for equity release – savings below a certain threshold, need money for car, home improvement – that is the trigger. But then they think what else do I need money for? And they will take out a plan with multiple reasons and do a number of different things." On average the research shows people use the money for more than two separate purposes.

Care homes fees
Many older people in care homes are being wrongly denied up to £62.25 a week towards their fees. The benefit is called Attendance Allowance and almost everyone ill enough to be in a home would be entitled to it. However, anyone who gets help with their fees from the local authority cannot claim Attendance Allowance. And this is where the errors creep in. Two groups can claim it, even where they are getting help with their costs. Everyone who needs nursing care in a home gets a contribution towards the cost. In England, Wales and Northern Ireland (but not in Scotland) this contribution does not prevent them getting attendance allowance as long as they pay the rest of the costs themselves. Second, anyone in a care home who has left their home empty or is renting it out can get their fees paid by the local authority. But when they die the home will be sold and their fees repaid to the council out of the proceeds. Although they are getting help from the council it is a loan and so they are still self-funding and can get Attendance Allowance. However, experts say that DWP staff are getting these complex rules wrong and denying both groups of people up to £62.25 a week that is rightfully theirs.

HIP swing
Just days before our critical column on the new Home Information Packs was published in the August Saga Magazine the Government announced a U-turn. Part of the HIPs will not be compulsory when they start in June next year. You will still need the local searches and legal information and you will still have to have an inspector calling to prepare an Energy Performance Certificate on how efficient your home is to heat and light. But the Home Condition Report on the fabric and structure of your home will not be compulsory – and may never be. Bad news for the 4500 people who are training – at their own expense – to be home inspectors who will now have much less to do. And bad news for estate agents who were hoping to make money out of HIPs – many saw their share price tumble. And not great news for sellers – the cut back pack will still have to be paid for and will give the buyer even less information.

New Saga guides
This month Saga is publishing its first free guide to money, which will be essential reading. Saga’s Guide to Pension Reform untangles the complicated reform of the pension system outlined by the Government in May. The guide, which I wrote, makes sense of the changes proposed in state and private pensions. You can get download it to your computer now from our new-look website. On the new website you can post your views about the proposed pension reforms and share your thoughts with other website users on these and many other issues.

September 2006

 


All material on these pages is © Paul Lewis 2006