Behind closed doors by Rachel
Normally I am a positive, upbeat person and most of my blogs (I hope!), have reflected this. But these past few months I have been feeling anything but these things. As a result this blog is on a more serious note.
As of 2003 the government brought in something called the Fairer Charging Policy, for calculating the contribution that domiciliary care clients pay towards their care packages. This is a nationwide policy but is implemented individually by each local council, following base guidelines set out by the government, but each making their own decisions about exactly what they will implement.
My own local council has recently decided to catch up with this policy and implement its own version which in simplistic terms currently entails taking 70 per cent of someones income, disability benefits and state pension included, for care charges. In basic terms we are suddenly expected to pay all our bills and live on 30% of our previous income. This means a huge budget change to the majority of people and with only three days notice, with many needing to find hundreds of pounds per month to pay for the care they need.
As someone who has other health issues as well as diabetes (not related), I am in receipt of a domiciliary care package which enables me to keep my independence. Up until now, as my only income was disability benefits I was below the income level to meet means testing for a contribution.
What does this have to do with diabetes I hear you say? Well, potentially a lot and this is why.
As we all know, the government and charities such as Diabetes UK are constantly producing information and campaigns to educate about diabetes and to improve care, both through the NHS and through self responsibility. This week alone I watched national news reports on diabetes care and how it needs to be improved, on 3 different days.
So why does the government (and then local councils), insist on forcing disabled and elderly people, including many diabetics such as myself, to have no choice but to change our previously healthy eating diet and lifestyle, in favour of cheaper, poorer ones, in favour of paying these charges?
I find myself with two choices, both of which will affect my health. Either I cancel my care altogether and avoid paying charges, or I change my lifestyle, diet and budget to pay. And as I said before, I am just one of thousands country wide being faced with this choice.
I have been forced to change from my low carb, healthy eating diet plan which has been a huge part of my diabetic control now for seven years, to simply eating what I can afford. The council have left me with just £20 a week to eat and pay for everything else life requires, such as travel costs to doctors and hospital appointments, toiletries and you can forget any social outings or hobbies. This is once my basic bills are paid (utilities, water, rent). I asked for health related expenses to be taken into account when these calculations were made, such as special diet and dietary supplements, but these were denied. They actually claim my disability related expenses are less than average!
I am proud of the fact that I have taken responsibility for my diabetes and taken control of it to the best of my ablity. As a consequence my diabetes has been under excellent control, I’ve managed to reduce the amounts of medications required and avoided many complications. My overall health has improved.
As a result of this dietary and lifestyle change I am already noticing changes to my health. I am having much more trouble controlling and maintaining level blood sugars, I have constant headaches and feel more lethargic and I have already had a bad UTI. This is all within one month of changing. I am doing my best to work out diet within my means but its proving very difficult.
What I just don’t understand, as a logical question, is how the councils and ultimately the government as this is their policy, believe this is supporting people and encouraging improved health? Particularly in this instance with diabetes, which is a very hot topic right now.
How do they think this is ultimately going to save money? The more people change their lifestyles for the worse, the more their health is going deteriorate. This leaves us open even more to the expensive complications of diabetes we are constantly lectured about costing the NHS millions every year. Not to mention increased hospital admission, another current hot topic! In the South West, where I live, we have just had the results of the nationwide care audit which show we are already suffering some of the poorest standards of diabetic care in the country and have many times higher than average rates of severe complications such as amputations.
As diabetics, how can we take responsibility for ourselves and try to help ourselves when you are forcing us into these situations? We see constant articles about poor lifestyle being responsible for the diabetic surge in our times, yet now this is what you want us to do and its ok with you?
To the Government and local authorities, I say, what is your actual plan here? To save money or to cost yourselves millions more cleaning up the consequences of these short sighted policies?!
We all know we are living in tough times and services are being cut to the bone, including local council budgets. But if you keep on cutting in the most vulnerable areas, such as community care it is going to have serious (and expensive), consequences. Yet again the hardest cuts are being put onto the most vulnerable in society.
These are very mixed messages and ultimately will cost people their lives. That’s the simple bottom line.
What makes it worse is that whilst the media is full of positive campaigns to improve care in diabetes and calls for more services and support to be implemented, this is going on quietly behind closed doors.