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Former head of Britain's nuclear deterrent to sue Matt Hancock over £5bn care 'scandal'

Joy Mathias before her illness, with son Rear Admiral Philip Mathias who is campaigning against inequalities in CHC funding
Joy Mathias before her illness, with son Rear Admiral Philip Mathias who is campaigning against inequalities in CHC funding
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The former head of Britain’s nuclear deterrent is suing Matt Hancock to force the NHS to pay for elderly patients’ long-term health costs.

If successful, the threatened judicial review by Rear Admiral Philip Mathias could cost the health service £5 billion in paid back medical fees.

The case concerns the failure by local NHS bosses to pay for the continuing healthcare (CHC) of tens of thousands of eligible patients a year.

It follows an investigation by The Telegraph which found that officials’ refusal to fund the costs was forcing patients to languish in hospital, or to pay sometimes hundreds of thousands out of their own pockets to manage conditions such as Parkinson's and dementia.

Under national CHC rules, any patient with a significant health problem should have their care and nursing fees paid in full by the NHS, provided their condition is the main reason they need help.

This is distinct from means-tested adult social care, which is funded by local councils.

However, analysis reveals an up to 20-fold variation in the chances of securing CHC funding between different NHS clinical commissioning groups.

Meanwhile NHS “snapshot” data shows that, nationally, the number of people eligible for long-term funding has actually gone down, despite an ageing population suggesting that the demand should be higher.

Patient charities have complained of a labyrinthine and attritional application process that forces patients to give up or wrongly persuades them they are not eligible.

Rear Admiral Mathias, former director of nuclear policy at the Ministry of Defence, believes up to 10,000 people are unlawfully denied CHC each year.

He was forced to fight a two-year battle involving more than 100 letters with Wiltshire CCG to recover £200,000 paid by his 90-year-old father to fund his mother, Joy’s, nursing home fees, which the organisation should have funded.

What is CHC?
What is CHC?

With the help of Ian Wise QC, he has now launched legal proceedings with the “strategic intent” of changing NHS behaviour across the country.

“In terms of the sheer scale of this scandal, measured by the significant number of old, ill and vulnerable people adversely affected and the huge level of unlawful financial deprivation, this is very possibly one of the biggest government scandals of modern times.”

Rear Admiral Mathias said that on the basis that the 50,000 people allegedly unlawfully denied CHC over the past five years had, on average, had to pay £100,000 - a “reasonable assumption”, he said - then the NHS could be liable for £5 billion, if the judicial review is successful.

He said a win in court could be the most significant judgment since that concerning payment protection insurance (PPI).

He added: “The Department of Health and Social Care and NHS have grossly violated the human rights of some of the most vulnerable people in society, descrimination based on age and disability, with many being unlawfully forced to sell their homes when their care should be funded by the NHS.”

The former submariner is launching a Crowd Justice appeal on Thursday to raise the £30,000 needed to fund the first stage of the judicial review.

A key plank of his case will be to challenge the secretary of state to explain the significant variations chances of receiving long-term health funding across the country.

Rebekah Carrier, who is running the litigation at Hopkin Murray Beskine, said: “It is often a huge and time consuming challenge for ill and vulnerable people to get the healthcare funding to which they are legally entitled. Many do not succeed, even when they should be eligible for NHS services which are “free at the point of delivery".

"There appears to be a systemic failure on the part of the Secretary of State and NHS England to ensure that health bodies make lawful decisions.

“This systemic failure is unlawful and we will be asking the Courts to take action to make sure that the law is followed".

Official figures show that since then, average eligibility per 50,000 population has fallen - from 68.77 per 50,000 in 2015/16 to 57.70 in 2018/19.

2019 figures also showed that show the number of people who were found to be eligible for CHC ranged from just 11.9 per 50,000 people in Luton, Bedfordshire, to 230.3 per 50,000 people in Salford, in Greater Manchester.

A Parliamentary briefing paper sets out NHS England’s efficiency plans, which require clinical commissioning groups (CCGs) “to make £855 million of savings on CHC and NHS-funded nursing care by 2020- 21”.

An NHS spokesperson said: “CHC funding is available to a minority of people whose eligibility is assessed on an individual level, while most people are instead covered by the rules on social care eligibility that Parliament has established."