§ Mr. BurstowTo ask the Secretary of State for Health (1) what guidance he has given to community health councils to assist them in advising self-funders in nursing homes of the decision in Coughlan v. North Devon health authority, C.A. 1999; [21392]
(2) when community health councils were given the information about Coughlan v. North Devon health authority, C.A. 1999 contained in circular HSC 1999/180: LAC (99) 30 of 11 August 1999; [21395]
(3) if health authorities pass confidential medical information to social services about potential self-funders before any decision accepted by the patient has been taken to withdraw free continuing care; [21394]
(4) if health authorities obtain the consent in writing of patients to become self-funders before free continuing care as defined by Coughlan v. North Devon health authority is withdrawn; [21396]
(5) if he will list the health authorities which have sought his Department's advice over applications for refunds made by self-funders since the decision in Coughlan v. North Devon health authority, C.A. 1999. [21391]
§ Jacqui Smith[holding answer 10 December 2001]Guidance regarding continuing care "Ex parte Coughlan: Follow up action", Health Service Circular 1999/180: Local Authority Circular (99) 30, was issued on 11 August 1999. Further guidance "Continuing Care: NHS and Local Councils' responsibilities" HSC 2001/015: LAC (2001)18 was issued on 28 June 2001. Guidance on "Free Nursing Care in Nursing Homes" HSC 2001/17: LAC(2001)26 was issued on 25 September 2001. Copies of all sets of guidance were sent routinely to community health councils' chief officers. No other guidance or advice has been has been specifically issued to CHCs.
It is for individual health authorities to ensure that their criteria for continuing national health service health care comply with guidance issued by the Department and to obtain their own legal advice where necessary. Since August 1999, only two health authorities have sought the Department's advice on the issue of 'refunds' for self funders: West Surrey health authority and South Essex health authority.
The determinations of any individual's requirement for continuing NHS health care or free nursing care are made on the basis of an assessment to determine individual needs. The introduction of free nursing care may lead to the identification of individuals with exceptional health needs who may now qualify for continuing NHS health care.
633WHealth authorities neither obtain consent in writing, nor do they pass confidential medical information to social services before 'withdrawing' continuing care; it is not envisaged, nor has it ever been brought to the Department's attention, that any health authority has behaved in the way described in the two questions. Once provided, continuing health care should continue to be provided unless and until the individual's healthcare needs change.