Community care means extra cost for disabled people

BMJ 1995; 311 doi: (Published 02 September 1995) Cite this as: BMJ 1995;311:588
  1. BMJ

    Nearly a fifth of disabled people in Britain have to turn down help from local authorities because they cannot afford the services, according to a survey on the impact of the government's policy on care in the community. The survey, commissioned by the charity Scope, says that many disabled people now have to pay for services that they previously received free.

    The survey was of more than 1500 disabled people and 1300 carers during the summer of 1994. What emerged was a picture of charges being introduced for services that had been provided free, means testing, and the rationing of essential support.

    In addition, only 13% of carers had received an assessment of need. Even when an assessment is provided, the report says that there is evidence of considerable dissatisfaction with the process: “Many respondents feel that assessors do not look at their individual lifestyles, but try and match them on narrow criteria. If they do not fit the boxes they do not receive the help they feel they are entitled to receive.”

    Many respondents reported problems with wheelchair services. Because of financial constraints the choice of chair is limited and recipients may face long delays in delivery. The report says: “Many people therefore have to buy privately or apply to charities for help in order to get a suitable wheelchair.”

    As far as medical care is concerned, 89% of disabled people and 84% of carers are satisfied with the service they receive from their general practitioner, although some disabled people were concerned that they might be viewed as a burden. Three quarters of disabled people and their carers are also happy with the service from their hospital doctor or consultant. Reservations focused chiefly on delays in diagnosis.

    The report states: “Disabled people and carers could benefit from GPs' increased freedom to purchase services for patients. Many practices are now adopting more holistic approaches which are especially suitable for the management of long term chronic and disabling conditions; for example, massage and stress relief clinics.”

    Brian Lamb, coauthor of the report and Scope's head of campaigns, said: “First hand experiences of disabled people and their carers show that community care is a system that is in danger of failing its original aim to improve quality, choice, and efficiency and has in fact forced many to rely on the unpaid care given by family and friends.”

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