Intended for healthcare professionals


Will intermediate care be the undoing of the NHS?

BMJ 2000; 321 doi: (Published 12 August 2000) Cite this as: BMJ 2000;321:393

Here's another bit of covert privatisation

  1. Allyson M Pollock, professor
  1. Health Services and Health Policy Research Unit, School of Public Policy, University College London, London WC1H 9QU

    The government has won praise for its new plan for the NHS,1 where it reaffirms its commitment to the principles of a universal comprehensive health service. Yet for the first time in its history NHS bodies will be able to levy charges for the personal elements of care. The commitment to services free at the point of delivery is absent from the NHS plan.

    Following the National Beds Inquiry2 the government has announced the creation of 7000 extra NHS beds by 2004, 5000 of which will be intermediate care beds and 1700 non-residential places. Intermediate care will “build a bridge between hospital and home” to speed discharge from acute care and provide a range of recovery and rehabilitation services. Cottage hospitals, private nursing homes, and domiciliary and community settings will form the heart of the new intermediate sector. What has received less attention is how these services will be funded.

    In the plan the government also published its response to the Royal Commission on Long Term Care.3 From October 2001 the NHS is committed to meet the costs only of nursing care for nursing home residents; personal care will be charged for. This means that in future nursing care will be free for all of the 160 000 nursing home residents in England who …

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