Letter: Defining the limits of NHS care for the aged

Sir: John Bowis will have to do a lot better than the lame semantics of his letter of 15 August if he attempts to rebut your excellent leading article 'NHS changes: a sense of betrayal' (16 August).

Care of the elderly and others with chronic illness has been the area in which patients have been most blatantly betrayed under the smokescreen of the new double-speak of community care, of which Mr Bowis's letter was a prime example. In order to prune expenditure in the NHS, large chunks of 'health' care are being redefined as 'social' care and removed from the free arena of the NHS to the private sector and the remit of the means-tested packages set up by the social services departments.

There has been a concerted effort to squeeze much of the NHS day-hospital and respite-care out of health and into the social care frame. The Government is clearly frightened at the increasing share of GDP that is going to be needed to pay for adequate care of our frail elderly over the next few decades and is trying to bale out of the responsibility, without making it explicit, in order to pursue its fantasy of further reduction in direct taxation.

Perhaps the Government should look at Canada, where the long-term care needs of the elderly have the same cover as their acute medical care, and to Germany, which is moving in that direction. There are electoral lessons from those countries, too - the decimation of an arrogant conservative party in Canada and the against-the-tide gains of Mr Kohl's more caring right in Germany.

Yours faithfully,

COLIN GODBER

Consultant in Old Age

Psychiatry

Southampton Community

Health Services

Southampton

16 August